Racecadotril in the Treatment of Acute Diarrhea in Pediatric Age: What is the Evidence?

Abstract

Acute gastroenteritis (AGE) remains one of the most frequent diseases in pediatric age with oral rehydration being the cornerstone of its treatment.
Racecadotril is an antidiarrheal drug used for the treatment of acute diarrhea in children, as it reduces the secretion of water and electrolytes by the digestive tract. Although it could be considered in the treatment of AGE, it is not clear whether racecadotril is really effective. The objective of this study is to assess whether there is evidence to support its use in the treatment of AGE in pediatrics, through a literature review.
A search of articles published in the last 10 years, in Portuguese or English, was carried out in the MEDLINE databases; NICE; Cochrane Library; BMJ; CPG Infobase - Clinical Practice Guidelines; Bandolier. The keywords used were “Racecadotril”, “Child”, “Child, Preschool”, “Diarrhea” and “Gastroenteritis”. The selection of articles was made in duplicate by the authors who, when in doubt, jointly discussed its inclusion/exclusion. The Strength of Recommendation Taxonomy scale was used to assign levels of evidence and strengths of recommendation.
A total of 443 articles were obtained, and in the end, eight articles were included: three meta-analyses, two reviews, two guidelines and one expert opinion.
The studies included in this review demonstrated a reduction in the number and volume of stools, in duration of diarrhea, and in healing time.
It is concluded that racecadotril seems to be effective in the treatment of acute diarrhea and can be considered in conjunction with the oral rehydration solution (SORT B).