Acute diarrhea: evidence-based management.

OBJECTIVES: To describe the current recommendations on the best management of pediatric patients with acute diarrheal disease.

DATA SOURCE: PubMed, Scopus, Google Scholar.

DATA SUMMARY: There has been little progress in the use of oral rehydration salts (ORS) in recent decades, despite being widely reported by international guidelines. Several studies have been performed to improve the effectiveness of ORS. Intravenous hydration with isotonic saline solution, quickly infused, should be given in cases of severe dehydration. Nutrition should be ensured after the dehydration resolution, and is essential for intestinal and immune health. Dietary restrictions are usually not beneficial and may be harmful. Symptomatic medications have limited indication and antibiotics are indicated in specific cases, such as cholera and moderate to severe shigellosis.

CONCLUSIONS: Hydration and nutrition are the interventions with the greatest impact on the course of acute diarrhea.