{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T06:43:38Z","timestamp":1775025818344,"version":"3.50.1"},"reference-count":75,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2016,8,1]],"date-time":"2016-08-01T00:00:00Z","timestamp":1470009600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. pediatr. gastroenterol. nutr."],"published-print":{"date-parts":[[2016,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective:<\/jats:title><jats:p>Acute gastroenteritis (AGE) is a major cause of child mortality and morbidity. This study aimed at systematically reviewing clinical practice guidelines (CPGs) on AGE to compare recommendations and provide the basis for developing single universal guidelines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p>CPGs were identified by searching MEDLINE, Cochrane\u2010Library, National Guideline Clearinghouse and Web sites of relevant societies\/organizations producing and\/or endorsing CPGs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>The definition of AGE varies among the 15 CPGs identified. The parameters most frequently recommended to assess dehydration are skin turgor and sunken eyes (11\/15, 73.3%), general appearance (11\/15, 66.6%), capillary refill time, and mucous membranes appearance (9\/15, 60%). Oral rehydration solution is universally recognized as first\u2010line treatment. The majority of CPGs recommend hypo\u2010osmolar (Na<jats:sup>+<\/jats:sup> 45\u201360 mmol\/L, 11\/15, 66.6 %) or low\u2010osmolality (Na<jats:sup>+<\/jats:sup> 75 mmol\/L, 9\/15, 60%) solutions. In children who fail oral rehydration, most CPGs suggest intravenous rehydration (66.6%). However, nasogastric tube insertion for fluid administration is preferred according by 5\/15 CPGs (33.3%). Changes in diet and withdrawal of food are discouraged by all CPGs, and early refeeding is strongly recommended in 13 of 15 (86.7%). Zinc is recommended as an adjunct to ORS by 10 of 15 (66.6%) CPGs, most of them from low\u2010income countries. Probiotics are considered by 9 of 15 (60%) CPGs, 5 from high\u2010income countries. Antiemetics are not recommended in 9 of 15 (60%) CPGs. Routine use of antibiotics is discouraged.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p>Key recommendations for the management of AGE in children are similar in CPGs. Together with accurate review of evidence\u2010base this may represent a starting point for developing universal recommendations for the management of children with AGE worldwide.<\/jats:p><\/jats:sec>","DOI":"10.1097\/mpg.0000000000001133","type":"journal-article","created":{"date-parts":[[2016,2,2]],"date-time":"2016-02-02T13:57:06Z","timestamp":1454421426000},"page":"226-235","source":"Crossref","is-referenced-by-count":64,"title":["Comparison of Recommendations in Clinical Practice Guidelines for Acute Gastroenteritis in Children"],"prefix":"10.1002","volume":"63","author":[{"given":"Andrea","family":"Lo Vecchio","sequence":"first","affiliation":[{"name":"Department of Translational Medical Sciences Section of Pediatrics University of Naples Federico II Naples Italy"}]},{"given":"Jorge Amil","family":"Dias","sequence":"additional","affiliation":[{"name":"Departamento de Pediatria M\u00e9dica Hospital de S\u00e3o Jo\u00e3o Porto Portugal"}]},{"given":"James A.","family":"Berkley","sequence":"additional","affiliation":[{"name":"KEMRI\/Wellcome Trust Research Programme Kilifi Kenya"}]},{"given":"Chris","family":"Boey","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Malaya Kuala Lumpur Malaysia"}]},{"given":"Mitchell B.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Alabama at Birmingham Birmingham"}]},{"given":"Sylvia","family":"Cruchet","sequence":"additional","affiliation":[{"name":"INTA Universidad de Chile Macul Chile"}]},{"given":"Ilaria","family":"Liguoro","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Sciences Section of Pediatrics University of Naples Federico II Naples Italy"}]},{"given":"Eduardo","family":"Salazar Lindo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Universidad Peruana Cayetano Heredia Lima Peru"}]},{"given":"Bhupinder","family":"Sandhu","sequence":"additional","affiliation":[{"name":"Department of Paediatric Gastroenterology Bristol Royal Hospital for Children Bristol United Kingdom"}]},{"given":"Philip","family":"Sherman","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Hospital for Sick Children University of Toronto Toronto Canada"}]},{"given":"Toshiaki","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Adolescent Medicine Juntendo University Graduate School of Medicine Tokyo Japan"}]},{"given":"Alfredo","family":"Guarino","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Sciences Section of Pediatrics University of Naples Federico II Naples Italy"}]}],"member":"311","published-online":{"date-parts":[[2016,8]]},"reference":[{"key":"e_1_2_13_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60549-1"},{"key":"e_1_2_13_3_2","doi-asserted-by":"publisher","DOI":"10.18356\/bb4c0cc6-en"},{"key":"e_1_2_13_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60560-1"},{"key":"e_1_2_13_5_2","doi-asserted-by":"publisher","DOI":"10.18356\/c495b58e-en"},{"key":"e_1_2_13_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2013-305429"},{"key":"e_1_2_13_7_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000350"},{"key":"e_1_2_13_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-12-62"},{"key":"e_1_2_13_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2011.02.006"},{"key":"e_1_2_13_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/MOG.0b013e32835a352f"},{"key":"e_1_2_13_11_2","volume-title":"Diarrhoea and Vomiting Caused by Gastroenteritis: Diagnosis, Assessment and Management in Children Younger Than 5 Years","author":"National Collaborating Centre for Women's and Children's Health (UK).","year":"2009"},{"key":"e_1_2_13_12_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-154-10-201105170-00011"},{"key":"e_1_2_13_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e3181e233ac"},{"key":"e_1_2_13_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000000396"},{"key":"e_1_2_13_15_2","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.157.10.978"},{"key":"e_1_2_13_16_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2010-2214"},{"key":"e_1_2_13_17_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-0473"},{"key":"e_1_2_13_18_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa064637"},{"key":"e_1_2_13_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e3182a1dd93"},{"key":"e_1_2_13_20_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-11-32"},{"key":"e_1_2_13_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e318272b5e2"},{"key":"e_1_2_13_22_2","volume-title":"Clinical Practice Guidelines: Directions for a New Program","author":"Institute of Medicine FM,","year":"1990"},{"key":"e_1_2_13_23_2","volume-title":"Ethnologue: Languages of the World","author":"Lewis MP","year":"2009"},{"key":"e_1_2_13_24_2","unstructured":"Ministry of Health NSW.Infants and children: Management of Acute Gastroenteritis. Fourth edition Clinical Practice Guideline\u2010GL2014_024. December 2014."},{"key":"e_1_2_13_25_2","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000000375"},{"issue":"1","key":"e_1_2_13_26_2","first-page":"1","article-title":"Guti\u00e9rrez\u2010Castrell\u00f3n P; Grupo Ibero\u2010Latinoamericano sobre el Manejo de la Diarrea Aguda (GILA).Gu\u00eda de pr\u00e1cticacl\u00ednica ibero\u2010latinoamericana sobre el manejo de la gastroenteritis aguda en menores de 5 a\u00f1os","volume":"80","author":"Salazar\u2010Lindo E","year":"2014","journal-title":"AnPediatr (Barc)"},{"key":"e_1_2_13_27_2","unstructured":"Princess Marina Hospital.Department of Paediatrics Protocols August 2012."},{"key":"e_1_2_13_28_2","doi-asserted-by":"publisher","DOI":"10.7196\/SAMJ.5243"},{"key":"e_1_2_13_29_2","unstructured":"World Gastroenterology Organisation Global Guidelines.Acute diarrhea in adults and children: a global perspective. February 2012."},{"key":"e_1_2_13_30_2","unstructured":"Ministry of Public Health and Sanitation (MOPHS).Scaling up strategy for essential treatments in children under five years in kenya: diarrhoea and pneumonia. Implementation Plan for the Period 2011\/12\u20102015\/16.www.publichealth.go.ke. Accessed May 15 2015."},{"key":"e_1_2_13_31_2","unstructured":"Acute Gastroenteritis Guideline Team Cincinnati Children's Hospital Medical Center: Evidence\u2010based care guideline for prevention and management of acute gastroenteritis in children age 2 months to 18 years.http:\/\/www.guideline.gov. Accessed June 1 2016."},{"key":"e_1_2_13_32_2","unstructured":"College of Paediatrics Academy of Medicine of Malaysia\/Malaysian Paediatric Association.Guidelines on the management of acute diarrhea in children;2011."},{"key":"e_1_2_13_33_2","first-page":"634","article-title":"Experts consensus on the principles of diagnosis and treatment of diarrheal diseases in children","volume":"47","author":"Subspecialty Groups of Gastroenterology and Infectious Diseases; Society of Pediatrics; Chinese Medical Association; Editorial Board of Chinese Journal of Pediatrics.","year":"2009","journal-title":"Zhonghua Er Ke Za Zhi"},{"key":"e_1_2_13_34_2","first-page":"22","article-title":"Evidence based guideline for the management of diarrhoea with or without vomiting in children","volume":"37","author":"Harris C","year":"2008","journal-title":"Aust Fam Physician"},{"key":"e_1_2_13_35_2","first-page":"380","article-title":"IAP Guidelines 2006 on management of acute diarrhea","volume":"44","author":"Bhatnagar S","year":"2007","journal-title":"Indian Pediatr"},{"key":"e_1_2_13_36_2","doi-asserted-by":"publisher","DOI":"10.1093\/pch\/16.3.177"},{"key":"e_1_2_13_37_2","doi-asserted-by":"publisher","DOI":"10.1093\/pch\/11.8.527"},{"key":"e_1_2_13_38_2","unstructured":"World Health Organization.The Treatment of Diarrhoea: A Manual for Physicians and Other Senior Health Workers. 4th rev.2005."},{"key":"e_1_2_13_39_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2010.00767.x"},{"key":"e_1_2_13_40_2","doi-asserted-by":"crossref","unstructured":"MusekiwaA VolminkJ. Oral rehydration salt solution for treating cholera: \u2264270\u200amOsm\/L solutions vs \u2265310\u200amOsm\/L solutions.Cochrane Database Syst Rev2011;CD003754.","DOI":"10.1002\/14651858.CD003754.pub3"},{"key":"e_1_2_13_41_2","unstructured":"MedWatch: The FDA Safety Information and Adverse Event Reporting Program.Zofran (ondansetron): Drug Safety Communication\u2010\u2010Risk of Abnormal Heart Rhythms Posted 09\/15\/2011;2011."},{"key":"e_1_2_13_42_2","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.12711"},{"key":"e_1_2_13_43_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-13-S3-S17"},{"key":"e_1_2_13_44_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-3667"},{"key":"e_1_2_13_45_2","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/20.4.1057"},{"key":"e_1_2_13_46_2","doi-asserted-by":"publisher","DOI":"10.5223\/pghn.2012.15.4.229"},{"key":"e_1_2_13_47_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpg.2012.11.004"},{"key":"e_1_2_13_48_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13312-011-0018-9"},{"key":"e_1_2_13_49_2","doi-asserted-by":"publisher","DOI":"10.1097\/MOG.0b013e32833f215d"},{"key":"e_1_2_13_50_2","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2014-307403"},{"key":"e_1_2_13_51_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0055063"},{"key":"e_1_2_13_52_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2004.05.035"},{"key":"e_1_2_13_53_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2007-3141"},{"key":"e_1_2_13_54_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arcped.2010.09.009"},{"key":"e_1_2_13_55_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2011-2985"},{"key":"e_1_2_13_56_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12098-012-0909-3"},{"key":"e_1_2_13_57_2","doi-asserted-by":"crossref","unstructured":"HahnS KimS GarnerP. Reduced osmolarity oral rehydrationsolution for treating dehydration caused by acute diarrhea in children.Cochrane Database Syst Rev2002;CD002847.","DOI":"10.1002\/14651858.CD002847"},{"key":"e_1_2_13_58_2","doi-asserted-by":"publisher","DOI":"10.1179\/2046904714Z.000000000218"},{"key":"e_1_2_13_59_2","unstructured":"World Health Organization.Management of severe acute malnutrition in infants and children.http:\/\/www.who.int\/elena\/titles\/full_recommendations\/sam_management\/en\/. Accessed June 1 2016."},{"key":"e_1_2_13_60_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2010-0952"},{"key":"e_1_2_13_61_2","doi-asserted-by":"publisher","DOI":"10.1177\/15648265140352S111"},{"key":"e_1_2_13_62_2","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2015-308821"},{"key":"e_1_2_13_63_2","first-page":"CD005433","article-title":"Lactose avoidance for young children with acute diarrhoea","volume":"10","author":"Macgillivray S","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_13_64_2","first-page":"CD005436","article-title":"Ronfani L Oral zinc for treating diarrhoea in children","volume":"1","author":"Lazzerini M","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_13_65_2","doi-asserted-by":"crossref","unstructured":"AlhashimiD AlhashimiH FedorowiczZ. Antiemetics for reducing vomiting related to acute gastroenteritis in children and adolescents.Cochrane Database Syst Rev2006;CD005506.","DOI":"10.1002\/14651858.CD005506.pub3"},{"key":"e_1_2_13_66_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2006.03231.x"},{"key":"e_1_2_13_67_2","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.162.9.858"},{"key":"e_1_2_13_68_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2011-000622"},{"key":"e_1_2_13_69_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0128754"},{"key":"e_1_2_13_70_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2008.03787.x"},{"key":"e_1_2_13_71_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2010.05.049"},{"key":"e_1_2_13_72_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-009-1274-y"},{"key":"e_1_2_13_73_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3062.2011.00668.x"},{"key":"e_1_2_13_74_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1207742"},{"key":"e_1_2_13_75_2","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-011-0231-4"},{"key":"e_1_2_13_76_2","first-page":"1","article-title":"Managing acute gastroenteritis among children: oral rehydration, maintenance, and nutritional therapy","volume":"52","author":"King CK","year":"2003","journal-title":"MMWR Recomm Rep"}],"container-title":["Journal of Pediatric Gastroenterology and Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1097\/MPG.0000000000001133","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,18]],"date-time":"2024-01-18T12:16:35Z","timestamp":1705580195000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1097\/MPG.0000000000001133"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,8]]},"references-count":75,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2016,8]]}},"alternative-id":["10.1097\/MPG.0000000000001133"],"URL":"https:\/\/doi.org\/10.1097\/mpg.0000000000001133","archive":["Portico"],"relation":{},"ISSN":["0277-2116","1536-4801"],"issn-type":[{"value":"0277-2116","type":"print"},{"value":"1536-4801","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,8]]}}}