[Management of infantile diarrhea by physicians in outpatient services in Peru].

This study investigated the practices followed by physicians in the clinical, therapeutic, and dietary management of children under the age of 5 with diarrhea. A total of 148 physicians were observed while they provided outpatient services at various public and private health institutions in two areas of Peru. They were also interviewed to assess their theoretical knowledge about the proper management of diarrhea in children. The physicians treated 222 children under 5 with diarrhea. It was observed that in taking their clinical histories the physicians ascertained the duration of the problem, the number of bowel movements, their consistency, and the presence of fecal mucus or blood in 175 (79%), 158 (71%), 140 (63%), and 153 (69%) cases, respectively. Antibiotics were prescribed for 130 children (58%), and 102 (46%) were not given any oral rehydration therapy (ORT). The oral rehydration salts (ORS) were recommended to only 40 (18%) of the children. On the other hand, during the interviews only 38 physicians (26%) indicated that they prescribe drugs for diarrhea, while 110 (74%) said that they recommend ORT. Fewer than half the mothers received recommendations regarding the type of food that they should give their children during the diarrhea episode. The results reveal a sizable discrepancy between theory and practice in the medical management of childhood diarrhea, which means that it is necessary to instill in physicians the importance of assessing and treating children with diarrhea according to a uniform and systematic scheme that includes careful therapeutic and dietary guidance.