Some times diarrhoea pts improve with antibiotics,indicating bacterial infection along with viral. Is not it ?
I am currently working on diarrhea project and I agree with what you mentioned. Actually that is what really differentiate between infectious and non infectious diarrhea; if the patient responds to antibiotic treatment, we can easily guess that the diarrhea is of bacterial origin. However, you need to take it account that, bacteria don not respond to a antibiotics due to antimicrobial drug resistance, which will miss lead the conclusion. Moreover, diarrhea that is caused by rota virus (the main cause of diarrhea among children under the age of 5) does not respond to antibiotic treatment.
I realize that WHO seem to think that morbidity and mortality under the age of 5y is homogeneous, but diarrhea in the first year of life is quite different to that in the fifth year.
Diarrhea less than 1 and less than 5 years of age have different etiologies and we should never mix these two. As per WHO about 88% of diarrhea-associated deaths are attributable to unsafe water, inadequate sanitation, and insufficient hygiene and Rota virus is the leading cause of acute diarrhea and causes about 40% of hospitalizations for diarrhea in children under 5. Patient may improve due to self limiting illness and not due to antibiotic use. However antibiotics kill all the normal flora also. So we must be careful while prescribing antibiotics
"As per WHO about 88% of diarrhea-associated deaths are attributable to unsafe water, inadequate sanitation, and insufficient hygiene"
I do not think diarrhoeal deaths in the first year of life are at all attributable to these factors. See my publications in Lancet, Nature and JAMA. The main factor is unskilled or compromised breastfeeding.
I agree with you; WHO mixes up both (less than 1 and less than 5 years of age) but Diarrhea have separate/ different etiologies for both and we should never mix these two age groups
Most of the time unable to define etiology in resource poor setting . How to decide about use of antibiotics?
"WHO mixes up both (less than 1 and less than 5 years of age) but Diarrhea have separate/ different etiologies for both and we should never mix these two age groups"
This is a very serious and more general criticism. I am interested in the cause(s) of (high) infant mortality, but find that studies in recent decades are worse than useless as all WHO seem to prioritize is under-5y mortality as a homogeneous lump. To get any clear thinking and data, I have to look in the Victorian literature, where meaningful distinctions were made. Even within IM, it was then recognized that causes of perinatal, neonatal and post-neonatal mortality were quite different. To WHOm it may concern, take note!
Thank you sir for clear concept.As you know infant death are not due to diarrhoea.In our set up these are mostly due to sepsis, low birth weight and birth asphyxia.
"As you know infant death are not due to diarrhoea."
The age group and era referred to need to be clarified. Today, in a developed country with low overall infant mortality, the causes just listed apply. In the old days, IM, and in particular post-neonatal mortality, was very high, and diarrhea was a prominent cause of PNIM. This still applies in some underdeveloped countries in the world.
- Badges
- Science topic
- Similar topics
- Medicine
- Disease
- Infectious Diseases