[RECOMMENDATIONS FOR THE DIAGNOSIS AND MANAGEMENT OF PEDIATRIC ACUTE GASTROENTERITIS IN ISRAEL - UPDATE 2017].

AIMS

The aim of these guidelines is to update and extend evidence-based recommendations for the diagnosis and management of children with acute gastroenteritis (AGE) in Israel, based on new data and the recently published European update.

METHODS

The recommendations, which are based on a systematic review of the literature, were graded by the level of evidence. The guidelines were endorsed by the Israeli societies for Pediatric Gastroenterology, Pediatric Infectious Diseases and the Israeli Association of Pediatrics.

RESULTS

Gastroenteritis severity is mainly linked to etiology, and rotavirus is most frequently associated with dehydration. Dehydration reflects severity and should be monitored by established score systems. Laboratory tests are generally not needed. Oral rehydration with hypo-osmolar solution is the major treatment and should start as soon as possible. Breast-feeding should not be interrupted; regular feeding should usually be continued with no dietary changes including milk. Data suggest that in the hospital setting, in non-breast-fed infants and young children, lactose-free feeds can be considered in the management of gastroenteritis. Antimicrobial therapy should be given in exceptional cases. Hospitalization should generally be reserved for children requiring enteral/parenteral rehydration, and most cases may be managed in an outpatients setting. Enteral rehydration is superior to intravenous rehydration.

CONCLUSIONS

Implementation of the scientifically-based guidelines in clinical practice may improve the standard of care of pediatric AGE in Israel.