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(Pediatrics in Review. 1997;18:221-223.)
© 1997 American Academy of Pediatrics

A Synopsis of the American Academy of Pediatrics' Practice Parameter on the Management of Acute Gastroenteritis in Young Children

This article provides a summary of the practice parameter on gastroenteritis. The reader is urged to refer to the original document for a more thorough presentation.¹

	Focus of the Parameter

 
Gastroenteritis was chosen as a topic for study because it is a common condition that can cause serious illness and death, especially in younger children. In addition, there is documented variation in how clinicians manage this disorder. Acute gastroenteritis is defined as diarrheal disease of rapid onset, with or without accompanying symptoms and signs such as nausea, vomiting, fever, or abdominal pain. The recommendations apply to children of 1 month to 5 years of age who otherwise are healthy and who live in developed countries. Most patients covered by the guideline will have viral or self-limited bacterial illness; however, the same principles can be applied to patients who have bacterial dysentery or protozoal disease.

The clinician managing a patient who has diarrhea must make many decisions, from whether to obtain a stool culture to when the child may return to child care. Three aspects of management were chosen for study, based on their clinical importance as well as the availability of data: rehydration, particularly the role of oral rehydration therapy (ORT); refeeding; and the use of antidiarrheal agents.

	Creation of the Parameter

 
The parameter was written by a committee consisting of three pediatric gastroenterologists, two pediatric infectious disease specialists, two pediatric epidemiologists, and a practitioner of general pediatrics, who served as chair. The work of the group was guided by the AAP's Provisional Committee on Quality Improvement

A literature search identified more than 4,000 potentially relevant documents, from which 230 were chosen for thorough evaluation. The findings in these articles were subjected to statistical analysis, which served as the basis for the subcommittee's recommendations. Statistical conclusions were augmented by consensus of the committee members. The document was subjected . . . [Full Text of this Article]