Oral therapy in children with cholera: a comparison of sucrose and glucose electrolyte solutions

Abstract

We performed a double-blind trial comparing sucrose electrolyte oral solution with glucose electrolyte oral solution in children less than 5 years of age with severe cholera-like diarrhea. Of 111 patients studied (102 with bacteriologically confirmed cholera), 55 received sucrose solution and 56 received glucose solution. The success rates, as defined by the absence of the need to give unscheduled intravenous therapy, were similar in the two groups (73% and 77% in the sucrose and glucose groups, respectively). There was no difference in purging rates between the two groups. The primary determinant of success for oral fluid regardless of the sugar was the purging rate. Sucrose malabsorption was responsible for oral therapy failure in one child. This study demonstrates that sucrose is an effective alternative to glucose in the oral therapy solution, but either must be used in conjunction with intravenous solution when treating severe dehydrating diarrhea.

PIP: This study compared, in children with cholera-like severe diarrhea, an oral glucose-electrolyte solution with an oral sucrose-electrolyte solution in equimolar amounts (WHO formula) in a double-blind manner. Of 111 patients, 55 were given sucrose and 56 glucose solutions. An absence of the need to use unscheduled intravenous therapy defined the success rate, which was similar in both groups: 73 and 77%, respectively, in the sucrose and glucose groups. Purgation rates also showed no difference between groups. The main determinant of success for oral fluid regardless of the sugar used was the purging rate. 1 failure of therapy in the sucrose group was attributed to sucrose malabsorption. It is concluded that sucrose is an effective alternative to glucose for oral rehydration therapy, but if the diarrhea has caused severe dehydration before the start of treatment, intravenous supplementation must also be used