Persistent diarrhoea

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Severe persistent diarrhoea is diarrhoea lasting 14 days or more and dehydrated.

• Start rehydration and refer to hospital.

Persistent diarrhoea is diarrhoea lasting 14 days or more but no dehydration.

• Advise on feeding (below), give vitamin A, and follow up in 5 days.

General notes: persistent diarrhoea

• if breastfeeding, give more frequent, longer breast feeds, day and night
• milk feeds should be mixed with maize meal porridge to reduce the concentration of lactose
• sour milk is better tolerated than fresh milk
• give fermented porridge if available
• give foods rich in vitamin A, folic acid and zinc- liver, kidney, dark green vegetables, fish, beans, groundnuts, breast milk, or vitamin supplements.

Indications for antibiotics in diarrhoea

Bloody diarrhoea, cramps and fever (dysentery):

First line:

	Medicine	Paed Dose	Frequency	Duration
	ciprofloxacin po	5-17 yrs: 20mg/kg (max 1.5gm/day)	twice a day	3 days
or	nalidixic acid po	4-<10kg: = 125mg >10kg: = 250mg 5-12yrs: = 375mg	4 times a day	5 days

Follow up after 2 days.

 

Second line (intestinal amoebiasis):

Medicine	Paed Dose	Frequency	Duration
metronidazole po	10mg/kg	3 times a day	5 days