Racecadotril, The Only Drug That Treats Acute Diarrhoea In Infants

Infant diarrhoea

The two leading cause of infant death in developing countries is malaria and diarrhoea. Over the years, the malaria related death have drop significantly. This can be attributed to the availability of preventive care and more effective drugs the malaria parasite is responsive to. However, with over 1.8 million under five years of age death due to diarrhoea annually, there is no drug for treating diarrhoea in children recommended by the world health organization (W.H.O). That is about to change with the introduction of racecadotril.
Before now, the WHO recommend the use of oral rehydration therapy for management of diarrhoea in children. This is no cure. It only reduce the effect of the diarrhoea. It is meant to replace lost electrolyte and water due to the diarrhoea. This is even the same thing the zinc in the oral rehydration therapy does.
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The WHO never recommend the use of loperamide drug for treating diarrhoea in children below 12 years of age. The drugs use in treating adults is not suitable for use in children. Loperamide is the main drug and it is anti motility drug that reduce the frequency of stool. Some side effects recorded with it include constipation. Oral rehydration therapy is also indicated for use in elderly and dehydrating diarrhoea.
The main cause of diarrhoea is infection called gastroenteritis. The above treatment does not fight the infection. Since most acute diarrhoea last about five days, the treatment works well for adults. But looking at a child as they still for five days is not a funny thing. This is the main reason for the inappropriate use of antibiotics which can lead to antibiotic resistance. The WHO does not recommend the use of antibiotics for the treatment of diarrhoea and should be reserve for more serious health challenges.

Racecadotril To The Rescue

First time anything about this drug was heard of was in 1990. A couple of countries have accepted it and several studies have been done on it. Some countries are still observing it while some few have refused vehemently that the evidence presented presently is not enough to give  a positive nod to it. The drug have not yet been included as one of the essential drugs in WHO formulary. A formal application have been filed to WHO to include it with evidence of efficacy.

What Is Racecadotril

Racecadotril is also known as acetorphan, it's active metabolite. It is a peripheral enkaphalinase inhibitor. Unlike the other opioid such as loperamide that is an anti motility agent, racecadotril reduce the secretion of water and electrolyte into the intestine. This then reduce the incidence and duration of acute diarrhoea and it's associated symptoms. No studies yet on chronic diarrhoea using racecadotril.
The drug is compared with loperamide in terms of efficacy and safety profile. From studies, it efficacy is slightly less it even equal to that if loperamide. In the aspects of side effect, it showed better safety profile with less side effects when compared to loperamide. The only side effect recorded in some few individuals so far is headache, rash and erythema.
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Above all, this drug is very suitable for infants and children. It is safe and effective for infants from two months and above. The dose varies as the age or weight of the child increases. It can be use together with oral rehydration therapy for up 100 years old person. It is a three times dosing.
Fortunately, this drug have found its way into the Nigeria. There is a drive now to push it into the market. How it will fair against some other existing antidiarrheal agents such as liquid kaolin that is suitable for three years old children and above is going to be tough. Although, this topic did not mention the side effects of liquid kaolin, it will still be a threat as medical doctors are usually more skeptical on the use of new medication.
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