Chapter 1.4 - Therapy of Viral Gastroenteritis

Abstract

Viral gastroenteritis is a common illness globally, affecting all ages, but causing the most severe disease in young children. Vomiting, diarrhoea, and dehydration with and without fever require appropriate management. The cornerstone of therapy is rehydration, combined with an age-appropriate diet. Oral rehydration solutions in cases of mild and moderate dehydration are as effective or better than intravenous rehydration and can be utilized in all settings, while intravenous rehydration may be required for rapid treatment of severe dehydration. There is no role for antibiotics in the management of uncomplicated viral gastroenteritis, or for antimotility agents in children. There is evidence of benefit for zinc and the antiemetic agent ondansetron, but other agents are not recommended for children. Some antisecretory agents and some probiotics have proved beneficial in a limited number of studies. Rigorously designed studies are needed to evaluate adjunct therapies, while emphasizing the importance of rehydration for viral gastroenteritis of any severity.