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2018 ; 18
(1
): 124
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Racecadotril in the treatment of acute diarrhea in children: a systematic,
comprehensive review and meta-analysis of randomized controlled trials
#MMPMID29614995
Eberlin M
; Chen M
; Mueck T
; Däbritz J
BMC Pediatr
2018[Apr]; 18
(1
): 124
PMID29614995
show ga
BACKGROUND: Racecadotril is a guideline-recommended option for the treatment of
acute diarrhea in children but existing guidelines and previous reviews of the
field are based on a small fraction of published evidence. Therefore, we have
performed a systematic search for randomized controlled trials evaluating
racecadotril as add-on or in comparison to other treatments. METHODS: A search
was performed in PubMed, Scopus and Google Scholar without limits about country
of origin or reporting language. A meta-analysis was conducted for the five most
frequently used efficacy parameters. RESULTS: We have retrieved 58 trials, from
nine countries including six in comparison to placebo, 15 in comparison to
various active treatments and 41 as add-on to various standard treatments (some
multi-armed studies allowing more than one comparison). Trials used 45 distinct
efficacy parameters, most often time to cure, % of cured children after 3 days of
treatment, global efficacy and number of stools on second day of treatment.
Racecadotril was superior to comparator treatments in outpatients and
hospitalized patients with a high degree of consistency as confirmed by
meta-analysis for the five most frequently used outcome parameters. For instance,
it reduced time to cure from 106.2 h to 78.2 h (mean reduction 28.0 h; P?0.0001
in 24 studies reporting on this parameter). Tolerability of racecadotril was
comparable to that of placebo (10.4% vs. 10.6% adverse events incidence) or that
of active comparator treatments other than loperamide (2.4% in both groups).
CONCLUSIONS: Based on a comprehensive review of the existing evidence, we
conclude that racecadotril is more efficacious than other treatments except for
loperamide and has a tolerability similar to placebo and better than loperamide.
These findings support the use of racecadotril in the treatment of acute diarrhea
in children.
|Acute Disease
[MESH]
|Antidiarrheals/adverse effects/*therapeutic use
[MESH]