Sunday, July 22, 2012

Managing diarrhoea . . . Complicating things

Yesterday, I was taking rounds when I came to a little boy, 11 months. He looked irritable and took my presence with much protest. I wondered why he should be admitted. 

The case sheet showed - 'Loose stools: 3 days. Being managed elsewhere. Baby has no relief'. 

There is no history of fever or any difficulty in feeding. There was couple of episodes of vomiting which has since settled . . .

I was interested in the 'management elsewhere' - 

And these were the list of medicines the little child was on - - -

1. A combination syrup of Salbutamol and Guiphenasin: 5 ml three times a day. 

2. Inj Ceftriaxone and Tazobactum - twice a day

3. Resicadrotil drops - 20 drops twice a day

4. Syr. Colistin Sulphate - 3 ml thrice a day

5. Inj Amikacin - one injection a day since the last 3 days

6. Neopeptine drops - 20 drops at night

7. Promethazine + Paracetamol syrup: 5 ml thrice a day

8. Ofloxacin + Metrogyl syrup: 5 ml thrice a day

9. Probiotic powder (Lactobacillus)

10. Dicyclomine drops: 5 drops thrice a day

11. Syrup Loperamide: 2 ml when needed

Well, I wonder if the little boy needs food at all . . . There would be no space in his little tummy after he's taken all those syrups . . .

This is the knowledge many of our doctors have about managing diarrhoea. 

You don't want to miss anything - so hit all the bacteria you've heard about or use all the antibiotics whose name you've heard of . . . I'm sure that if they had heard about any anti-virals, that would have also been started. . .

Below is a snap of all the medicines . . .




The worst part of the prescription. There was no Oral Rehydration Solution at all. . . If the doctor had added ORS to the prescription, that would have made it 12 medicines to treat a case of diarrhoea. . . 

We've stopped all medications. The baby's doing well . . . 



2 comments:

  1. even specialists and super specialists perform such atrocities...it is either the greed or the urgency to recover the money spent on their medical "education". It all boils down to why you took up the profession.

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  2. Rarely have i seen any group of qualified doctors other than community health specialists (and very few pediatricians) restricting their prescription to ORS, even if it is a history of just one day.
    in our centre we've managed to convince them that ORS actually stops the diarrhoea. The parent responds with a smirk if you suggest Home-made fluids.

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