Racecadotril in the management of acute diarrhea in children: what is the evidence? Review article
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Published:
Jun 20, 2022
Keywords:
acute diarrhea, gastroenterocolitis, antidiarrheal drugs
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Abstract
Acute infectious diarrhea, also known as acute gastroenteritis, is a common childhood disease. The most frequent and severe threat posed by diarrhea is dehydration. Oral rehydration with hypoosmolar solution is the major treatment and should start as soon as possible. As oral rehydration solution neither reduces the frequency of bowel movements and fluid loss nor shortens the duration of illness, it decreases its acceptance and prompts interest in adjunctive treatments. Racecadotril is an antisecretory drug that exerts its antidiarrheal effects by inhibiting intestinal enkephalinase. Here, the evidence for racecadotril in the management of acute diarrhea in children is reviewed.
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Szajewska , H. (2022). Racecadotril in the management of acute diarrhea in children: what is the evidence?. Medycyna Faktow (J EBM), 15(2(55), 130-135. https://doi.org/10.24292/01.MF.0222.2
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References
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2. Shane A, Mody R, Crump J et al. 2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea. Clin Infect Dis. 2017; 65: 1963-73.
3. Guarino A, Lo Vecchio A, Dias JA et al. Universal Recommendations for the Management of Acute Diarrhea in Nonmalnourished Children. J Pediatr Gastroenterol Nutr. 2018; 67: 586-93.
4. Schwartz JC. Racecadotril: a new approach to the treatment of diarrhoea. Int J Antimicrob Agents. 2000; 14: 75-9.
5. Baumer P, Danquechin Dorval E, Bertrand J et al. Effects of acetorphan, an enkephalinase inhibitor, on experimental and acute diarrhoea. Gut. 1992; 33: 753-8.
6. Hinterleitner TA, Petritsch W, Dimsity G et al. Acetorphan prevents cholera-toxin-induced water and electrolyte secretion in the human jejunum. Eur J Gastroenterol Hepatol. 1997; 9: 887-91.
7. Gordon M, Akobeng A. Racecadotril for acute diarrhoea in children: systematic review and meta-analyses. Arch Dis Child. 2016; 101(3): 234-40.
8. Liang Y, Zhang L, Zeng L et al. Racecadotril for acute diarrhoea in children. Cochrane Database Syst Rev. 2019; 12: CD009359.
9. Eberlin M, Chen M, Mueck T et al. Racecadotril in the treatment of acute diarrhea in children: a systematic, comprehensive review and meta-analysis of randomized controlled trials. BMC Pediatr. 2018; 18(1): 124. http://doi.org/10.1186/s12887-018-1095-x.
10. Mahraoui L, Heyman M, Plique O et al. Apical effect of diosmectite on damage to the intestinal barrier induced by basal tumour necrosis factor-alpha. Gut. 1997; 40: 339-43.
11. Turck D, Berard H, Fretault N et al. Comparison of racecadotril and loperamide in children with acute diarrhoea. Aliment Pharmacol Ther. 1999; 13(suppl 6): 27-32.
12. Chung KT, Stevens SE Jr, Lin WF et al. Growth inhibition of selected foodborne bacteria by tannic acid, propyl gallate andrelated compounds. Lett Appl Microbiol. 1993; 17: 29-32.
13. Scalbert A. Antimicrobial properties of tannins. Phytochemistry. 1991; 30: 3875-83.
14. Frasca G, Cardile V, Puglia C et al. Gelatin tannate reduces the proinflammatory effects of lipopolysaccharide in human intestinal epithelial cells. Clin Exp Gastroenterol. 2012; 5: 61-7.
15. Florez ID, Sierra JM, Niño-Serna LF. Gelatin tannate for acute diarrhoea and gastroenteritis in children: a systematic review and meta-analysis. Arch Dis Child. 2020; 105: 141-6.
16. Kołodziej M, Bebenek D, Konarska Z et al. Gelatine tannate in the management of acute gastroenteritis in children: a randomised controlled trial. BMJ Open. 2018; 8(5): e020205.
17. Baumer P. Racecadotril: side effects and tolerability. In: Manfredi M (ed). Racecadotril: an effective anti-diarrheal drug. Nova Science Pub Inc. 2020: 211-37.
18. Rautenberg TA, Zerwes U, Lee WS. Cost utility, budget impact, and scenario analysis of racecadotril in addition to oral rehydration for acute diarrhea in children in Malaysia. Clinicoecon Outcomes Res. 2018; 10: 169-78.
19. Rautenberg TA, Zerwes U. The cost utility and budget impact of adjuvant racecadotril for acute diarrhea in children in Thailand. Clinicoecon Outcomes Res. 2017; 9: 411-22.
20. Rautenberg TA, Zerwes U, Foerster D et al. Evaluating the cost utility of racecadotril for the treatment of acute watery diarrhea in children: the RAWD model. Clinicoecon Outcomes Res. 2012; 4: 109-16.
21. Pienar C, Benninga MA, Broekaert IJ et al. Drugs in Focus: The Use of Racecadotril in Paediatric Gastrointestinal Disease. J Pediatr Gastroenterol Nutr. 2020; 70(2): 162-4.
2. Shane A, Mody R, Crump J et al. 2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea. Clin Infect Dis. 2017; 65: 1963-73.
3. Guarino A, Lo Vecchio A, Dias JA et al. Universal Recommendations for the Management of Acute Diarrhea in Nonmalnourished Children. J Pediatr Gastroenterol Nutr. 2018; 67: 586-93.
4. Schwartz JC. Racecadotril: a new approach to the treatment of diarrhoea. Int J Antimicrob Agents. 2000; 14: 75-9.
5. Baumer P, Danquechin Dorval E, Bertrand J et al. Effects of acetorphan, an enkephalinase inhibitor, on experimental and acute diarrhoea. Gut. 1992; 33: 753-8.
6. Hinterleitner TA, Petritsch W, Dimsity G et al. Acetorphan prevents cholera-toxin-induced water and electrolyte secretion in the human jejunum. Eur J Gastroenterol Hepatol. 1997; 9: 887-91.
7. Gordon M, Akobeng A. Racecadotril for acute diarrhoea in children: systematic review and meta-analyses. Arch Dis Child. 2016; 101(3): 234-40.
8. Liang Y, Zhang L, Zeng L et al. Racecadotril for acute diarrhoea in children. Cochrane Database Syst Rev. 2019; 12: CD009359.
9. Eberlin M, Chen M, Mueck T et al. Racecadotril in the treatment of acute diarrhea in children: a systematic, comprehensive review and meta-analysis of randomized controlled trials. BMC Pediatr. 2018; 18(1): 124. http://doi.org/10.1186/s12887-018-1095-x.
10. Mahraoui L, Heyman M, Plique O et al. Apical effect of diosmectite on damage to the intestinal barrier induced by basal tumour necrosis factor-alpha. Gut. 1997; 40: 339-43.
11. Turck D, Berard H, Fretault N et al. Comparison of racecadotril and loperamide in children with acute diarrhoea. Aliment Pharmacol Ther. 1999; 13(suppl 6): 27-32.
12. Chung KT, Stevens SE Jr, Lin WF et al. Growth inhibition of selected foodborne bacteria by tannic acid, propyl gallate andrelated compounds. Lett Appl Microbiol. 1993; 17: 29-32.
13. Scalbert A. Antimicrobial properties of tannins. Phytochemistry. 1991; 30: 3875-83.
14. Frasca G, Cardile V, Puglia C et al. Gelatin tannate reduces the proinflammatory effects of lipopolysaccharide in human intestinal epithelial cells. Clin Exp Gastroenterol. 2012; 5: 61-7.
15. Florez ID, Sierra JM, Niño-Serna LF. Gelatin tannate for acute diarrhoea and gastroenteritis in children: a systematic review and meta-analysis. Arch Dis Child. 2020; 105: 141-6.
16. Kołodziej M, Bebenek D, Konarska Z et al. Gelatine tannate in the management of acute gastroenteritis in children: a randomised controlled trial. BMJ Open. 2018; 8(5): e020205.
17. Baumer P. Racecadotril: side effects and tolerability. In: Manfredi M (ed). Racecadotril: an effective anti-diarrheal drug. Nova Science Pub Inc. 2020: 211-37.
18. Rautenberg TA, Zerwes U, Lee WS. Cost utility, budget impact, and scenario analysis of racecadotril in addition to oral rehydration for acute diarrhea in children in Malaysia. Clinicoecon Outcomes Res. 2018; 10: 169-78.
19. Rautenberg TA, Zerwes U. The cost utility and budget impact of adjuvant racecadotril for acute diarrhea in children in Thailand. Clinicoecon Outcomes Res. 2017; 9: 411-22.
20. Rautenberg TA, Zerwes U, Foerster D et al. Evaluating the cost utility of racecadotril for the treatment of acute watery diarrhea in children: the RAWD model. Clinicoecon Outcomes Res. 2012; 4: 109-16.
21. Pienar C, Benninga MA, Broekaert IJ et al. Drugs in Focus: The Use of Racecadotril in Paediatric Gastrointestinal Disease. J Pediatr Gastroenterol Nutr. 2020; 70(2): 162-4.