Pratibha S. Worlikar

In clinical practice, nonspecific antidiarrheals (allopathic and ayurvedic) are most commonly used by clinicians along with routine treatment to hasten the recovery and to give psychological reassurance. Although they are used extensively in practice, studies comparing their efficacy are few. This prospective observational study was carried out at two private clinics run by pediatricians to compare the efficacy, safety, and tolerability of racecadotril versus MEBARID, an ayurvedic polyherbal antidiarrheal formulation in the treatment of acute diarrhea. Children aged 2 y to 10 y who presented to the clinic with acute diarrhea and fulfilling selection criteria were enrolled and divided into two treatment groups viz, racecadotril and MEBARID. Data collection was done using predesigned case report forms and questionnaires. Outcome Measures used were 1)Duration of diarrhea after initiation of treatment 2)Frequency of stools until recovery 3)Time required for improvement in stool consistency. The groups were comparable clinically and demographically at enrolment. There was no significant difference in time needed for improvement in stool consistency with both racecadotril and MEBARID (17.76h vs.18.60h).Patients on racecadotril passed  3.32  ± 0.15 stools before recovery, while patients on MEBARID passed 3.13 ± 0.13 stools. The mean duration of treatment was less for racecadotril group (28.68 ± 2.18h Vs. 37.60 ± 2.18h; P = 0.005). Rapid improvement in stool consistency and frequency was found with both drugs. Thus racecadotril and MEBARID are rapid, equally effective treatments for acute diarrhea in children, but racecadotril significantly reduces the duration of diarrhea compared to MEBARID.