What are the recommended rehydration strategies for managing acute infectious diarrhoea in children and adults?

For children with acute infectious diarrhoea, the recommended rehydration strategy is to use low-osmolarity oral rehydration salt (ORS) solution (240–250 mOsm/l) for oral rehydration therapy (ORT), administering 50 ml/kg for fluid deficit replacement over 4 hours along with maintenance fluids, and giving ORS frequently and in small amounts (NICE, 2009; Shane, 2017) ¹,².

In children with clinical dehydration, including hypernatraemic dehydration, ORS solution should be used to rehydrate, with 50 ml/kg given over 4 hours, and the response monitored regularly (NICE, 2009; Shane, 2017) ¹,².

For adults, the WGO guidelines recommend oral rehydration therapy (ORT) as a cost-effective method, emphasizing the use of low-osmolarity ORS solutions, and advise against fruit juices and carbonated drinks as they are hyperosmolar and can worsen diarrhoea symptoms (Farthing, 2012) ¹.

Both children and adults should be encouraged to continue breastfeeding and normal fluid intake during rehydration, and solid foods should be reintroduced after initial rehydration (NICE, 2009; Shane, 2017) ¹,².