Racecadotril does little for acute diarrhea in young children

Takeaway

• Racecadotril offers little benefit for acute diarrhea in children under age 5 years, say the authors of this Cochrane review.
• It might reduce risk for rehydration failure, but any effect on number of bowel movements or duration of diarrhea is uncertain.

Why this matters

• For children under age 5 years, acute diarrhea is a leading cause of death, largely because of fluid and electrolyte loss.
• These authors say that current evidence does not support use of racecadotril in children under age 5 years as an adjunct to oral rehydration therapy.

Key results

• The 7 included randomized controlled trials were conducted in France, Spain, India, Kenya, Peru, and Ecuador.
• Vs placebo or no treatment, racecadotril was tied to reduced risk for rehydration failure (risk ratio, 0.41; 95% CI, 0.13-1.23), but evidence from the 2 relevant trials (n=192) was low certainty.
• Not enough data were available for conclusions regarding duration of diarrhea or number of stools.
• Racecadotril was not associated with reduced hospital stay.
• It was not tied to increased adverse event rates.

Study design

• Cochrane review of 7 randomized controlled trials assessing racecadotril vs no treatment or placebo in children under age 5 years.
• Funding: Sichuan University, China; Liverpool School of Tropical Medicine, UK; others.

Limitations

• The limitations are those of the included trials.