The objective of the study, carried out on the basis of the Department of Pediatrics of the University of Naples Federico II (Naples, Italy), was to assess the applicability and effectiveness of the implementation of practical recommendations for the management of children with acute gastroenteritis on an outpatient basis.

To achieve this objective, a national, open, randomized and controlled intervention study was conducted. The intervention included a 2-hour training course for pediatricians helping children on an outpatient basis, with practical recommendations for the care of patients with acute gastroenteritis. The study group included 75 randomly selected pediatricians providing primary medical care who received specialized training in the management of children with acute gastroenteritis; the control group consisted of 75 physicians who were not specially trained on this issue. Each pediatrician included 10 children aged 1 to 36 months with acute diarrhea in the clinical study. As main results, the applicability of practical recommendations to doctors, the duration of diarrhea in patients and the differences in body weight of children between the first visit and the 5-7th day of the study were evaluated.

The baseline characteristics of children with acute diarrhea included in the study by physicians in the study (n = 617) and control (n = 692) groups were comparable. A total of 404 children in the study group (65.5%) and 20 of the 692 children in the control group (3%) who were diagnosed with acute gastroenteritis were completely treated according to practical recommendations. Most deviations from the recommendations included the appointment of unnecessary drugs or drugs whose effectiveness and diets had not been proven.

The duration of diarrhea was shorter in the study group (when analyzing all the patients to be treated, ITT analysis, 83.3 hours vs 90.9 hours, p less than 0.001). The increase in body weight was slightly (however, statistically significant) more in children treated according to the recommendations (analysis according to the protocol +16.5 g vs -13.5 g, p less than 0 , 05).

Thus, practical recommendations for the management of patients with acute gastroenteritis are highly acceptable and effective, and additional medical interventions only lead to an increase in the duration of diarrhea.