Use of bismuth subsalicylate in acute diarrhea in children

Results of a pilot study suggest that bismuth subsalicylate (BSS) favorable altered the course of rotavirus-associated diarrhea in children. This was more evident in those who also had a bacterial pathogen. Subsequently 123 infants and children with acute diarrhea were admitted to a randomized parallel double-blind placebo- controlled clinical trial. Patients received either BSS at a dosage of 100 mg/(kg x d) for 5 days or a placebo. Patients in the 2 groups were comparable with respect to age sex weight height and baseline disease parameters. Compared with subjects treated with placebo those who received BSS had significantly lower stool weight sooner improved stool consistency sooner shorter hospital stay fewer number of stools decreased need for intravenous fluids and better evolution of clinical condition. The maximum mean serum level of salicylate occurred on day 3 and the mean blood level of bismuth on the last day of dosing (day 5) was 5.8 ppb. (authors)