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Treatment for Gastroenteritis in children - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Child Health
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1773 Questions
User :   Hi, my 3 year old daughter is having vomiting, loose stools and fever from 4 days. The doctor prescribed Emeset, Taxim-o, and Crocin syrup. vomiting was suppressed with Emeset syrup and it did not last for long. Loose stules and at times high temperature continued. After 4 days doctor changed the antibiotic to Ofloxacin 50mg+Metronidazole 100mg suspension. Is it safe to use that in children below 5 ?
Doctor :   Hi
User :   Hi Doctor
User :   Hope you have gone through the above question I first posted to start with
Doctor :   Ok
Doctor :   Let me brief you.
Doctor :   Fluoroquinonlone drugs can induce cartilage growth disturbances.
Doctor :   Ofloxacin is a fluoroquinolone.
Doctor :   The cartilage effects are less common with ofloxacin when compared to ciprofloxacin which is another medication in the same group.
User :   ok
Doctor :   The safety of metronidazole in children is also not known.
Doctor :   However pediatrician world wide use these medications regularly in children with no major complications.
User :   oh ok. I was reading some adverse effects of these components and thought to confirm
User :   By the way, as per the condition of my child ( she was weighing 14.7 on the first day of infection, and now lost some weight not sure how much)
Doctor :   So, I would say, though both the medications can cause adverse effects on growing children, it is widely used in treatment of infections regularly.
User :   Would you prefer to continue with these medications ?
User :   Today it appreared that the loose stules improved a very little bit from watery kind of
Doctor :   It is apparent that your daughter is suffering from gastroenteritis.
User :   ok
Doctor :   Plenty of organisms ranging form bacteria, virus tropozoites and amoeba can cause gastrointestinal infections.
Doctor :   Without physically examining your daughter and without the aid of stool sample tests, its hard to predict the type of organism causing the infection.
Doctor :   The medication prescribed to your daughter are effective in all the infection except the viral one.
User :   ok, the other doctor said if she is not improving today also ( 5th day), we need to do stules test and blood test
Doctor :   Get the stool tests done which will confirm the type of infections and the right antibiotic that is needed.
Doctor :   In the mean time, more important than the antibiotics is
Doctor :   fluid and electrolyte replenishment.
Doctor :   You need to keep giving her fluids as long as she continues to have loose stools.
Doctor :   Use ORS/electrolyte packages that your doctors have prescribed to you.
User :   she is refusing but we are some how giving in at least 1 hour interval. ORS mixed in water, and rice soup (we call it Ganji) not sure if you are familiar
Doctor :   You can discuss with your doctor and add lactobacillus supplementation (sporolac sachets/bifilac sachets to the treatment)
User :   the doctor prescribed a probiotic yesterday
Doctor :   Yes continue giving her the fluids and rice porridge.
Doctor :   watch out for signs of dehydration.
User :   how do we know that the fluid intake is not sufficient so that we need to take her to a hospital for better care ?
Doctor :   The signs of dehydration are reduced tears, drowsiness, very dry skin,
User :   ok
Doctor :   reduced urination both frequency and amount,
Doctor :   refusal to feed and drink,
Doctor :   Dry tongue.
Doctor :   These are the few symptoms that you can watch out for.
Doctor :   If she develops such symptoms, it is better that she is hospitalized.
Doctor :   she will need IV fluid supplementation.
User :   ok, the doctor saw her yesterday evening too, so I assume these symptoms were not there at least till that time
User :   it it was viral, will it stay for this long ?
User :   I mean, onto the 5th day ?
Doctor :   Dehydration can come up, if loose stools are persisting and if there is no proper oral fluid replacement.
Doctor :   So watch out for them.
User :   sure Doctor
Doctor :   Viral infections are self limiting illness.
Doctor :   It is not very common for viral infection to last for more than 2-3 days.
Doctor :   However depending on her previous general condition, symptoms can last for a week to 10 days.
User :   ok, doing a stool examination alone can help identify the right medication ?
User :   or a blood examination also is required ?
Doctor :   However it is very odd to find viral symptoms lasting for more than 2-3 days. Evaluations are definitely indicated if they occur
Doctor :   Stool samples result is to be considered in deciding the appropriate antibiotics.
Doctor :   However if the fever is high and very frequent, doctor can consider the result of the blood culture too in deciding the right antibiotic.
Doctor :   Have you followed what I have suggested?
Doctor :   Do you have any other query?
User :   yes, very much. The fever part, it was reaching a higher range in the first 2 days (around above 102). However, yesterday and today it is less. We were giving crocin every 4th hours, but yesterday doctor said continue only if she measures more than 100
Doctor :   It is essential that you give her crocin only when you feel the temperature is high.
User :   after yesterday evening 4:30 pm (given at that time), it reached 100 only once at midnight around 1:30 AM
Doctor :   As round the clock crocin can suppress fever from happening.
User :   and today so far, she has not crossed 99
Doctor :   This will create confusion in the minds of the doctor.
User :   ok
Doctor :   If fever is reducing, then it is an indication that infection is settling.
Doctor :   This will assist the doctor to decide upon the future course of action.
Doctor :   Hope it is clear to you.
Doctor :   Do you have any other query?
User :   great to hear that doctor. Unlike viral, if it is settling, it should not behave crazy again , right ?
Doctor :   That
Doctor :   That's right.
User :   Thanks a lot for your expert opinions doctor. Thats all I have from my side
Doctor :   I do not expect the symptoms to recurr unless the infection are salmonella one
Doctor :   where in there is a small percentage of cases where recurrence can happen.
User :   salmonella ? Do you have time to just brief this in few seconds
User :   ok
Doctor :   Salmonella is a bacterial infection.
User :   ok
Doctor :   In layman's term you can refer it to as typhoid infection.
Doctor :   They can present with similar symptoms.
Doctor :   It is diagnosed based on the blood culture reports and widal tests.
User :   ok. so without going for a blood culture, will the doctor be able to identify the type of bacteria also ?
User :   oh ok, so the stool examination can just decide if it is viral or bacteria
Doctor :   A blood culture and Widal tests are essential in diagnosing the condiition.
Doctor :   Based on your description, the symptoms are probably related to non salmonella infections, however since I haven't physically examined her,
Doctor :   it is hard to rule the infection out without a physical examination.
Doctor :   so go for the blood and stool tests, if symptoms persist or recur.
User :   Thank you Doctor. Your help is greatly appreciated
Doctor :   Hope it is clear.
Doctor :   Do you have any other query?
User :   thats all from my end.
Doctor :   Thanks for consulting me.
Doctor :   Wish your daughter a speedy recovery.
Doctor :   Bye for now.
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