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Baby has diarrhoea. Prescribed with Azithromycin,Promethazone hydrochloride. No relief. Treatment?

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Pediatrician, Infectious Diseases
Practicing since : 2005
Answered : 1528 Questions
Question six month old duaghter have been diagnosed with diarrhea
...she have been passing XXXXXXX watery stools since three dayd and 8 times a day.She is urinating after every 3 hours.She has completely refused milk and we are trying to keep her hydrated with water.Doctor has prescribed Azithromycin and promethazone hydrocloride but nothing seems to be working...Please help
Posted Tue, 22 May 2012 in Child Health
Answered by Dr. Hema Yadav 3 hours later
Thanks for posting your query.
Your daughter is suffering from infective diarrhoea.
Most of the infantile diarrhoeas are caused by gastroenteritis by viral infections more commonly than bacterial infection.Sometimes this is the reason why antibiotics doesn't seem to be effective in some cases where the symptoms resolve on their own after a certain period.
Another possibility could be that the bacteria causing the infection could be resistant to the antibiotic prescribed (azithromycin).
If she has already completed three days of the antibiotic course she should have shown some signs of improvement like decreased frequency or consistency of stools, return of apetite etc.
Since there is no significant improvement, I would advise the following measures,
1.The most important step which you are doing well and should continue doing is maintaining the childs hydration by giving WHO recommended oral rehydration solution as sips throughout the day and keep monitoring her urine output.At present her urine output is adequate.
2.You should consult her pediatrician and get a stool routine and culture& antibiotic sensitivity test done which will help in knowing the exact causative organism and the antibiotic for it's eradication.Alternatively your doctor might start another antibiotic like colistin or cefixime which are specially useful in infantile diarrhoea ,empirically if indicated.
3.Apart from antibiotics and hydration your doctor might advise you supportive treatment in the form of probiotics lactobacillus (enterogermina , econorm etc)and multivitamin and zinc supplements(becozinc, Zn2O etc)which provide some symptomatic relief.
4.During diarrhoea many infants are unable to digest milk hence lactose free casein or soy based formulas( like nusobee etc) may be given as per your doctors prescription.
So please do not worry and discuss it with your treating doctor as soon as feasible.
Hope I have answered your query.

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