Focus on acute diarrhoeal disease

Table 1 Symptomatic therapy of diarrhea

Opiates	Drug	Dose
&mgr;-receptor agonists	Diphenoxylate	2.5-5 mg qid
	Loperamide	2-4 mg qid
	Codeine	15-60 mg qid
	Morphine	2-20 mg qid
Enkephalinase inhibitors δ-receptor	Racecadotril	1.5 mg/kg tid
Adrenergic agonists	Clonidine	0.1-0.3 mg tid
Somatostatin analogue	Octreotide	30-250 &mgr;g tid
Bile acids binding substances	Cholestyramine	4-16 g/die
Fibers	Psyllium	10-20 g/die

Table 2 Comparison of Racecadotril (100 mg tid) and Loperamide (1-6 mg/die) in the treatment of acute diarrhea in adults

Author, yr	Patients (n)	Study design	Time to resolution (h)	P
Frexinos J, 1996	574	d.b. randomized	28.9 vs 26.8	NS
Vetel JM, 1999	147	d.b. randomized	14.9 vs 13.7	NS
Prado D, 2002	945	s.b. randomized	55 vs 55	NS
Wang HH, 2005	62	s.b. randomized	19 vs 13	NS

NS: Not significant.

Table 3 TD risk according to country and destination

Country of origin	Country of destination (%)
	Low	Average	High
Low	2-4	10-20	20-40
Average	2-4	Indeterminate	901
High	2-4	ND	8-18

¹Selected groups (e.g. Nile Cruises); ND: Not available.

Table 4 Food risk scale

Low risk (increasing)	High risk (decreasing)
Coffee, tea (served hot)	Puddings (> with unbaked creams)
Foods served at > 60°C	Tap water, ice
Fruit peeled by consumer	Cooked shellfish
Freshly-squeezed fruit	Cheese
Soft drinks in general	Cold collation
Bread	Spicy sauces
Bottled mineral water	Salads and raw vegetables
Butter	Milk