Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, Naples, Italy (ESPGHAN).
Department of Pediatrics, University of the Philippines Manila - Philippine General Hospital, Institute of Pediatrics and Child Health, St. Luke's Medical Center, Quezon City, Philippines (APPSGHAN).
J Pediatr Gastroenterol Nutr. 2020 May;70(5):694-701. doi: 10.1097/MPG.0000000000002669.
The incidence of gastroenteritis has greatly reduced due to improved hygiene conditions in developing countries and the use of rotavirus vaccine. Still thousands of children, however, die from gastroenteritis, most of them in poor countries. Yet gastroenteritis management is simple, inexpensive, and effective and is largely the same all over the world. Universal guidelines for gastroenteritis guide the management and include simple interventions put forward early in the course of the disease. Treatment includes rehydration, continuing oral feeding, and anti-infective drugs in selected clinical conditions related to the symptoms or to host-related risk, and possible additional drug treatment to reduce the duration and severity of symptoms. There may be minor geographical differences in the treatment applied due to health care organizations that do not substantially change the standard universal recommendations. Prevention is recommended with sanitation interventions and rotavirus universal immunization. Implementation of those interventions through educational initiatives and local programs in target areas are needed. A series of recommendations for interventions, education, and research priorities are included here with the aim of reducing the burden of gastroenteritis, to be pursued by scientists, physicians, policy makers, and stakeholders involved. They include the need of recommendations for the management of gastroenteritis in malnourished children, in those with chronic conditions, in neonates, and in emergency settings. A reference system to score dehydration, the definition of optimal composition of rehydration solution and the indications for anti-infective therapy are also included. Rotavirus immunization should be actively promoted, and evidence-based guidelines should be universally implemented. Research priorities are also indicated.
由于发展中国家卫生条件的改善和轮状病毒疫苗的使用，肠胃炎的发病率大大降低。然而，仍有成千上万的儿童死于肠胃炎，其中大多数在贫穷国家。然而，肠胃炎的治疗方法简单、廉价且有效，而且在全世界基本相同。肠胃炎管理的通用指南指导治疗，包括在疾病早期提出的简单干预措施。治疗包括补液、继续口服喂养以及在与症状相关或与宿主相关的风险相关的特定临床情况下使用抗感染药物，以及可能的额外药物治疗以减轻症状的持续时间和严重程度。由于医疗保健组织可能会因地理位置的不同而在应用的治疗方法上存在细微差异，但这些差异不会改变标准的通用建议。建议通过卫生干预措施和轮状病毒普遍免疫来预防肠胃炎。需要在目标地区通过教育计划和地方计划来实施这些干预措施。这里包含了一系列干预措施、教育和研究重点的建议，旨在通过科学家、医生、政策制定者和利益相关者的共同努力来减轻肠胃炎的负担。其中包括需要为营养不良儿童、慢性病患者、新生儿和急诊环境中的肠胃炎管理制定建议。还包括了脱水评分参考系统、补液最佳成分的定义以及抗感染治疗的指征。应积极推广轮状病毒免疫接种，并普遍实施基于证据的指南。还指出了研究重点。
