Heimann G
Monatsschr Kinderheilkd. 1984 May;132(5):303-5.
The management of acute diarrhea in infants with drugs is justified only where these drugs have specific interactions with the pathophysiologic mechanisms involved. Most of the infectious diarrheas are self-limited, many patients recover spontaneously. Antimicrobial drugs are only indicated if mucosal destruction takes place and symptoms of dysentery respectively inflammation are observed. Some authors propose to treat newborn and young infants in case of doubt. If antimicrobial drugs are given uncritically a selection of not obligatory microorganisms can occur, or the number of asymptomatic carriers increases. There is no confirmation that drugs like adsorbents (kaolin, pectin, charcoal) or lyophilized microorganisms have a therapeutic effect. In contrast morphine derivatives like loperamide act not only by slowing the intestinal motility but also by inhibiting the secretion mechanisms of the enterocyts. Nevertheless these drugs can not be recommended for infants since ileus symptoms have been observed.
仅当药物与所涉及的病理生理机制有特定相互作用时,使用药物治疗婴儿急性腹泻才是合理的。大多数感染性腹泻是自限性的,许多患者可自行康复。仅在发生黏膜破坏且观察到痢疾或炎症症状时才使用抗菌药物。一些作者建议在存疑的情况下治疗新生儿和幼儿。如果不加区分地使用抗菌药物,可能会出现非必需微生物的选择,或者无症状携带者数量增加。没有证据证实吸附剂(高岭土、果胶、木炭)或冻干微生物等药物具有治疗作用。相比之下,洛哌丁胺等吗啡衍生物不仅通过减缓肠道蠕动起作用,还通过抑制肠细胞的分泌机制起作用。然而,由于已观察到肠梗阻症状,这些药物不推荐用于婴儿。