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Suggest Treatment For Loose Stool In A Child After An Antibiotic Course
Posted on
Tue, 23 Jun 2015
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Tue, 23 Jun 2015
Answered on
Thu, 16 Jul 2015
Last reviewed on
Question : Greetings for the day !Last week my 7 months old daughter (she is on teething) was diagnosed with sore throat, fever. She was prescribed 5 days antibiotic and Antic P and later Cinril for cough. The course was duly completed and then from the 7th day onwards she started having vomitings and stopped taking milk. We have been giving her lots of fluids, sugar salted water etc. Our consultant has prescribed Entergermnia and Vomisave. Now she has started off with watery and loose stools and she has been prescribed OFM suspension. Is the treatment ok and how should we proceed? Will the loose stools and her apetite get well without antibiotics? She has become very pale and weak. What diet should we give?
Brief Answer:
It seems to be a case of antibiotic associated diarrhoea
Detailed Answer:
Thanks for asking on HealthcareMagic.
I have gone carefully through the details provided. It seems that the antibiotics that were previously given for sore throat, killed the normal bacteria and is responsible for the passage of loose stools. This is called antibiotic associated diarrhoea and I would not recommend the use of OFM unless you have already started the course. In case you have started the medication, you should complete the course to avoid development of antibiotic resistance. Irrespective of your interventions, it would take 3-5 days to recover.
Enterogermina is the right thing to be given. Also give curd or yogurt since it contains similar helpful bacteria. The mainstay of treatment would be proper hydration. You need to frequently give her ORS (oral rehydration solution) sip by sip. If the amount of fluid intake is equal to or greater than the amount of fluid lost through stool, she would be fine and her weakness will resolve.
About diet, there is no specification except for the suggestion to avoid milk for a week or so. A rice based diet is preferrable. You can boil rice along with pulses and vegetables and give it in mashed form.
Hope that helps.
Regards
It seems to be a case of antibiotic associated diarrhoea
Detailed Answer:
Thanks for asking on HealthcareMagic.
I have gone carefully through the details provided. It seems that the antibiotics that were previously given for sore throat, killed the normal bacteria and is responsible for the passage of loose stools. This is called antibiotic associated diarrhoea and I would not recommend the use of OFM unless you have already started the course. In case you have started the medication, you should complete the course to avoid development of antibiotic resistance. Irrespective of your interventions, it would take 3-5 days to recover.
Enterogermina is the right thing to be given. Also give curd or yogurt since it contains similar helpful bacteria. The mainstay of treatment would be proper hydration. You need to frequently give her ORS (oral rehydration solution) sip by sip. If the amount of fluid intake is equal to or greater than the amount of fluid lost through stool, she would be fine and her weakness will resolve.
About diet, there is no specification except for the suggestion to avoid milk for a week or so. A rice based diet is preferrable. You can boil rice along with pulses and vegetables and give it in mashed form.
Hope that helps.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks for your reply. Had a few questions:
1. Was the treatment of giving antibiotic for sore throat and fever fine although nothing can be done about it now but at least for the future we can be cautious ?
2. Its has been 3 days since my daughter has been vomiting and today she started off with loose stools. We waited for 3 days without OFM and had her on Bifilac for 2 days and then Enterogermina, Vomisave from yesterday onwards. It is from today afternoon that we have given the 1st dose of OFM suspension. Whether we should continue with OFM? She has no fever as of now.
3. Can soy milk be given to her?
4.She is avoiding water at times. She is not eating . Will she feel hungry without milk?
5. How long will it take for her to get back to normal routine?
1. Was the treatment of giving antibiotic for sore throat and fever fine although nothing can be done about it now but at least for the future we can be cautious ?
2. Its has been 3 days since my daughter has been vomiting and today she started off with loose stools. We waited for 3 days without OFM and had her on Bifilac for 2 days and then Enterogermina, Vomisave from yesterday onwards. It is from today afternoon that we have given the 1st dose of OFM suspension. Whether we should continue with OFM? She has no fever as of now.
3. Can soy milk be given to her?
4.She is avoiding water at times. She is not eating . Will she feel hungry without milk?
5. How long will it take for her to get back to normal routine?
Brief Answer:
You need to give ORS. Coax her to eat - someway or the other.
Detailed Answer:
Thanks for writing back. Let me try to answer your queries one by one:
* Most often sore throat is either caused due to bacteria like Streptococcus or viruses like Epstein Barr virus. In either case, irrespective of use of antibiotics it takes 5-7 days to recover. Some doctors prefer to give antibiotics. So I would not be judgmental about it. These organisms are everywhere and there is nothing to be cautious about except for avoidance of cold which depresses our immunity making us catch the infection.
* Since you have started OFM, you must complete the course. Bifilac and Enterogermina are more or less the same, so giving any one would be fine. I gave you my preference for yogurt in this regard. Vomisave can be given as and when required to bring vomiting in control.
* Soy milk can be given. No problems with the same.
* If other food principles are given, not giving milk should not be an issue. In any case gradually you should move to the mashed version of adult food low on spices. Children do not feed well when ill. So, you will have to coax her to eat. But please do not force feed.
* It would take her a week or so to be initially ok. The remaining recovery will take a few weeks. But you need not worry. If adequate fluids are given, she should be fine soon.
Hope that helps.
Regards
You need to give ORS. Coax her to eat - someway or the other.
Detailed Answer:
Thanks for writing back. Let me try to answer your queries one by one:
* Most often sore throat is either caused due to bacteria like Streptococcus or viruses like Epstein Barr virus. In either case, irrespective of use of antibiotics it takes 5-7 days to recover. Some doctors prefer to give antibiotics. So I would not be judgmental about it. These organisms are everywhere and there is nothing to be cautious about except for avoidance of cold which depresses our immunity making us catch the infection.
* Since you have started OFM, you must complete the course. Bifilac and Enterogermina are more or less the same, so giving any one would be fine. I gave you my preference for yogurt in this regard. Vomisave can be given as and when required to bring vomiting in control.
* Soy milk can be given. No problems with the same.
* If other food principles are given, not giving milk should not be an issue. In any case gradually you should move to the mashed version of adult food low on spices. Children do not feed well when ill. So, you will have to coax her to eat. But please do not force feed.
* It would take her a week or so to be initially ok. The remaining recovery will take a few weeks. But you need not worry. If adequate fluids are given, she should be fine soon.
Hope that helps.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Good Evening Doctor !
Your advice has been really helpful. My daughter has now started showing signs of improvement. Today is the 3rd day of OFM suspension and Vomisave and Enterogermina. My queries are as follows:
1. She has no vomitings or loose stools as of now. For how long should we continue with the above medications?
2. She doesn't like eating salty things like ORS, Dal/ khichdi etc. Is it ok if we give her mashed Banana? Is it ok to give her mother's feed?
3. She has 4 front teeth coming. Is it ok to give Bio D3 right now? What other medication etc. can you suggest for teething? Is homeopathethic Calcariafos ok?
4. What other tonics or iron supplements can be given to her because she looks pale? And when can we start with these?
5. She is persistently trying very hard or pushing herself as if there is some sort of gas trouble or constipation in her stomach. What could be the reason?
6. Any other advice for a 7 month old baby
Regards
Your advice has been really helpful. My daughter has now started showing signs of improvement. Today is the 3rd day of OFM suspension and Vomisave and Enterogermina. My queries are as follows:
1. She has no vomitings or loose stools as of now. For how long should we continue with the above medications?
2. She doesn't like eating salty things like ORS, Dal/ khichdi etc. Is it ok if we give her mashed Banana? Is it ok to give her mother's feed?
3. She has 4 front teeth coming. Is it ok to give Bio D3 right now? What other medication etc. can you suggest for teething? Is homeopathethic Calcariafos ok?
4. What other tonics or iron supplements can be given to her because she looks pale? And when can we start with these?
5. She is persistently trying very hard or pushing herself as if there is some sort of gas trouble or constipation in her stomach. What could be the reason?
6. Any other advice for a 7 month old baby
Regards
Brief Answer:
It is good to know that the vomiting and loose motion has stopped
Detailed Answer:
Thanks for writing back.
1. It is good to hear that the vomiting and diarrhoea have stopped. You should give OFM for a total of 5 days and then stop. Give Vomisave only if there is vomiting. Enterogermina can be given for another 2-3 days.
2. You can give mashed banana or whatever she desires to eat. Mother's breast milk is a very good thing to be given.
3. It is absolutely ok to give BioD3 now. There is no medication for teething. The teeth come in natural way and in due course. I cannot comment on Calcariafos but I do not think that you need to give it.
4. Tonoferon drops 0.8 ml once a day can be given for iron supplementation. You can start it alongside.
5. Unless the stool is hard and pellet like, you need not assume it to be constipation. But you must give enough vegetables along. Boil them along with rice and pulses and give in mashed form. That will prevent constipation from occurring.
6. Keep the baby clean. Periodically follow up with your doctor. Immunise as per schedule. That is all I have to say at the moment.
Hope it helps.
Regards
It is good to know that the vomiting and loose motion has stopped
Detailed Answer:
Thanks for writing back.
1. It is good to hear that the vomiting and diarrhoea have stopped. You should give OFM for a total of 5 days and then stop. Give Vomisave only if there is vomiting. Enterogermina can be given for another 2-3 days.
2. You can give mashed banana or whatever she desires to eat. Mother's breast milk is a very good thing to be given.
3. It is absolutely ok to give BioD3 now. There is no medication for teething. The teeth come in natural way and in due course. I cannot comment on Calcariafos but I do not think that you need to give it.
4. Tonoferon drops 0.8 ml once a day can be given for iron supplementation. You can start it alongside.
5. Unless the stool is hard and pellet like, you need not assume it to be constipation. But you must give enough vegetables along. Boil them along with rice and pulses and give in mashed form. That will prevent constipation from occurring.
6. Keep the baby clean. Periodically follow up with your doctor. Immunise as per schedule. That is all I have to say at the moment.
Hope it helps.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Good evening Doctor!
Thanks for your advice!
We did not give Vomisave today to the baby. She was given Enterogermina, ZNG syrup,OFM and Bio D3. Today in the morning she had 5 ounces of soy milk, passed her motion twice (one was ok and the other one little loose) and slept. Then she was fed some mashed rice and some rice water and she slept at about 3 pm in the afternoon.
Again she was fed with about 4.5 ounces of soy milk. She got up abruptly at 5 and vomited the entire milk.
1. How should we proceed further now?
2. Is there anything to worry given the fact that its been almost 3 days since she has been given OFM and Vomisave?
3. How should we go about feeding her?
Thanks and Regards
Thanks for your advice!
We did not give Vomisave today to the baby. She was given Enterogermina, ZNG syrup,OFM and Bio D3. Today in the morning she had 5 ounces of soy milk, passed her motion twice (one was ok and the other one little loose) and slept. Then she was fed some mashed rice and some rice water and she slept at about 3 pm in the afternoon.
Again she was fed with about 4.5 ounces of soy milk. She got up abruptly at 5 and vomited the entire milk.
1. How should we proceed further now?
2. Is there anything to worry given the fact that its been almost 3 days since she has been given OFM and Vomisave?
3. How should we go about feeding her?
Thanks and Regards
Brief Answer:
There is nothing to grow apprehensive about.
Detailed Answer:
Thanks for writing back. Things seem normal to me.
1. Please do not grow apprehensive. Just complete the medicines as directed. Nothing more needs to be done. She would soon be fine and just continue with normal healthy living.
2. No there is nothing to worry.
3. You have to coax her to eat. Do not force-feed. You can give a rice based diet along with soy milk. You can come back to regular food a week after she becomes well again.
Hope that helps.
Regards
There is nothing to grow apprehensive about.
Detailed Answer:
Thanks for writing back. Things seem normal to me.
1. Please do not grow apprehensive. Just complete the medicines as directed. Nothing more needs to be done. She would soon be fine and just continue with normal healthy living.
2. No there is nothing to worry.
3. You have to coax her to eat. Do not force-feed. You can give a rice based diet along with soy milk. You can come back to regular food a week after she becomes well again.
Hope that helps.
Regards
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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