Racecadotril for acute diarrhoea in children

What was the aim of this review?

The aim of this Cochrane Review was to find out whether racecadotril works for children under five years of age with diarrhoea. Cochrane Review authors collected and analysed all relevant trials to answer this question and included seven trials in this review.

Key messages

Racecadotril may reduce the risk of rehydration failure. We are uncertain whether or not it influences number of bowel movements or duration of diarrhoea.

What was studied in the review?

Diarrhoea is a leading cause of death in children under five years old, especially in low‐income countries. Children who have diarrhoea often suffer from frequent and watery bowel movements, which might cause excessive loss of fluid and electrolytes (dehydration). Fluid replacement is recommended to prevent and treat dehydration caused by diarrhoea. Racecadotril has been used in addition to fluid replacement for treating diarrhoea in children, as it reduces release of water and electrolytes into the digestive tract. The drug is supposed to improve the symptoms of diarrhoea (shorten duration of diarrhoea or reduce the stool frequency) as well as reduce the risk of rehydration failure. However, it is not clear if racecadotril really works for children with diarrhoea.

What are the main results?

The review authors searched for available trials and included seven trials. The trials were conducted in a total of 1140 children aged from 3 months to 5 years. Children who were given racecadotril were compared to a control group (children who, instead of racecadotril, received a placebo (a dummy drug that contains no racecadotril) or no drug). The review shows that when children with diarrhoea were given racecadotril, compared to placebo or no drug:

• racecadotril may reduce the risk of rehydration failure (low‐certainty evidence);
• we are uncertain whether or not racecadotril shortens duration of diarrhoea (very low‐certainty evidence);
• we are uncertain whether racecadotril influences the number of stools (very low‐certainty evidence);
• racecadotril may reduce weight of stool output (low‐certainty evidence);
• racecadotril may make little or no difference to length of hospital stay for inpatients (low‐certainty evidence);
• racecadotril may make little or no difference to rates of side‐effect events (low‐certainty evidence)

How up to date is this review?

The review authors searched for trials published up to 4 March 2019.