INDICES> Racecadotril (Acetorphan) (2)

["Randy Trinkle" <rtrinkle@gumby.citytel.net>]

INDICES> Racecadotril (Acetorphan) (2)
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See contact information for the principal investigator at the bottom 
of the abstract:

The New England Journal of Medicine
 -- August 17, 2000 -- Vol. 343, No. 7

Racecadotril in the Treatment of Acute Watery Diarrhea in Children

Eduardo Salazar-Lindo, Javier Santisteban-Ponce, Elsa Chea-Woo, 
Manuel Gutierrez

Background. Racecadotril (acetorphan), an enkephalinase inhibitor 
with antisecretory and antidiarrheal actions, is an effective and safe 
treatment for acute diarrhea in adults and children. Whether 
treatment with racecadotril and oral rehydration therapy is more 
effective than treatment with oral rehydration alone in hospitalized 
children with acute watery diarrhea is not known.

Methods. We treated 135 boys 3 to 35 months of age who had 
watery diarrhea of five days' duration or less with racecadotril (1.5 
mg per kilogram of body weight orally every eight hours) or 
placebo, in addition to oral rehydration solution. The primary end 
point was the 48-hour stool output (measured in grams); the total 
stool output, duration of diarrhea, and total intake of oral 
rehydration solution were also measured.

Results. The mean (±SE) 48-hour stool output was 92±12 g per 
kilogram in the racecadotril group and 170±15 g per kilogram in the 
placebo group (P<0.001), a 46 percent reduction with racecadotril. 
The results were similar among the 73 boys with rotavirus 
infections. The total stool output was 157±27 g per kilogram in the 
racecadotril group and 331±39 g per kilogram in the placebo group 
(P<0.001). The median duration of diarrhea was significantly less 
(P<0.001) in the racecadotril group (28 hours regardless of rotavirus 
status) than in the placebo group (72 and 52 hours, respectively, 
for rotavirus-positive and rotavirus-negative patients). The intake of 
oral rehydration solution was significantly lower in the racecadotril 
group than in the placebo group (P<0.001).  Racecadotril was well 
tolerated; only seven patients taking racecadotril had adverse 
effects, which were all mild and transient.

Conclusions. In young boys with acute watery diarrhea, 
racecadotril is an effective and safe treatment.

>From the Department of Pediatrics, Hospital Nacional Cayetano 
Heredia, Lima, Peru. Address reprint requests to Dr. Salazar-Lindo 
at Av. Benavides 264, Of. 501, Miraflores, Lima 18, Peru, or at 
edsal@upch.edu.pe .


*******************************
Randy Trinkle, BScPharm BA
Clinical Pharmacist
Prince Rupert Regional Hospital
Prince Rupert, BC
Health Science Links:
http://www.rupert.net/~rtrinkle

[so what? Is the amount of stools a clinically relevant outcome? Did they measure dehydration status?
What is the cost? What were the sideeffects? Do we now give this as an additional drug to ORS? WB]

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