Dawaa Reference

infectious

Acute Gastroenteritis in Infants

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources4 sources

ESPGHAN/ESPID Evidence-Based Guidelines for Acute Gastroenteritis in Children 2014 for the indication, with the figures from Egyptian National Drug Formulary - GIT medicines 2025, ondansetron monograph (endf-git.txt): "IV single dose: 0.15 mg/kg given immediately before chemotherapy (must not exceed 8 mg)" and "> 10 kg Up to 3 doses of 0.15 mg/kg IV every 4 hours 4 mg syrup or tablet every 12 hours". The formulary states those figures for chemotherapy-induced vomiting; the gastroenteritis indication is the ESPGHAN guideline's, which is not held in this corpus. · WHO/UNICEF IMCI Guidelines 2014 · ESPGHAN/ESPID Evidence-Based Guidelines for Acute Gastroenteritis in Children 2014 · WHO. The treatment of diarrhoea: a manual for physicians and other senior health workers, 4th rev. Geneva: WHO; 2005 (IRIS 10665/43209), section 4.3.1 and Table 2

Verified against5 documents
  • ESPGHAN/ESPID Evidence-Based Guidelines for Acute Gastroenteritis in Children 2014 for the indication, with the figures from Egyptian National Drug Formulary - GIT medicines 2025, ondansetron monograph (endf-git.txt): "IV single dose: 0.15 mg/kg given immediately before chemotherapy (must not exceed 8 mg)" and "> 10 kg Up to 3 doses of 0.15 mg/kg IV every 4 hours 4 mg syrup or tablet every 12 hours". The formulary states those figures for chemotherapy-induced vomiting; the gastroenteritis indication is the ESPGHAN guideline's, which is not held in this corpus.
  • WHO/UNICEF IMCI Guidelines 2014
  • ESPGHAN/ESPID Evidence-Based Guidelines for Acute Gastroenteritis in Children 2014
  • WHO. The treatment of diarrhoea: a manual for physicians and other senior health workers, 4th rev. Geneva: WHO; 2005 (IRIS 10665/43209), section 4.3.1 and Table 2
  • Acute Gastroenteritis in Infants - disease-level clinical article (gastroenteritis-in-infants-clinical.txt)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (4)

  • Watery diarrhea with 3 or more bowel movements a day, often with nausea, vomiting, fever, or abdominal pain, defines the condition [abdominal pain · diarrhoea · fever · nausea · vomiting]
  • Onset is usually sudden, over 1 to 2 hours, and other household or close contacts often have similar symptoms
  • Symptoms typically resolve within 1 to 3 days and are labeled chronic if they persist beyond 2 weeks
  • High fever, bloody stools, ongoing vomiting, or severe abdominal pain point away from a simple viral cause [abdominal pain · bloody diarrhoea · diarrhoea · fever · vomiting]

Signs — what you find (2)

  • A fever over 39 C, or tachycardia and tachypnea from dehydration, should raise concern for a non-viral cause [dehydration · fever · tachycardia · tachypnoea]
  • Exam usually shows only mild, diffuse abdominal tenderness; guarding, rebound, or a focal tender point suggests another diagnosis [abdominal tenderness · guarding · rebound tenderness]

Tests (4)

  • Well-hydrated patients without risk factors for severe disease generally do not need further testing beyond clinical assessment
  • A blood count can show mild leukocytosis, and significant dehydration may show hemoconcentration or electrolyte shifts
  • Abdominal imaging is usually normal; CT is used mainly to exclude other, more serious causes rather than confirm this diagnosis
  • Stool studies are reserved for bloody stool, high fever, severe pain, or severe dehydration, since routine assays only detect bacteria

If not this — what else fits (4)

  • Bacterial toxin food poisoning looks similar and is usually managed the same way as this condition
  • Atypical symptoms should raise suspicion for Salmonella, E coli, Shigella, Campylobacter, Giardia, or C difficile, which need different treatment
  • Appendicitis, diverticulitis, IBD, bowel obstruction, and cholecystitis are commonly missed and misdiagnosed as this condition
  • Viral upper respiratory infections and some bacterial pneumonias can mimic these symptoms too

Scores

  • WHO dehydration classification (child with diarrhoea) — How dehydrated is this child, and which rehydration plan?

SourceStatPearls "Viral Gastroenteritis" - disease-level clinical article

Presentation findings are traced to the source above.

1

ORS

1st line

Formoral.liquid

Adult dose and duration

Not applicable - pediatric entry x 3-5 days

Paediatric dose

Some dehydration: give the infant's weight in kg x 75 mL of ORS solution over the first 4 hours, plus 10 mL/kg for each further loose stool. Continue breastfeeding throughout. Reassess fully at 4 hours.

Dose source

WHO. The treatment of diarrhoea: a manual for physicians and other senior health workers, 4th rev. Geneva: WHO; 2005 (IRIS 10665/43209), section 4.3.1 and Table 2

Why

Glucose-electrolyte solution that uses the co-transport of sodium and glucose across the intact gut mucosa to replace fluid and electrolyte losses from diarrhoea, preventing dehydration and reducing the need for hospitalisation without requiring IV access.

Cautions
  • CORNERSTONE OF MANAGEMENT: Reduced osmolarity ORS prevents hospitalization.
  • DO NOT stop breastfeeding or dilute infant formula.
  • RED FLAGS: Lethargy, sunken eyes, skin pinch >2 sec, persistent vomiting, blood in stool — refer urgently for IV fluids.
Egyptian brands
Egyptian brandManufacturerIndicative price
GLUCOHYDRAN 10 SACHET.ARAB DRUG COMPANY (ADCO)1.75 EGP
REHYDRAN N 10 SACHETCID4.50 EGP
REHYDRO ZINC 10 SACHETSCID7.00 EGP
ORS 20 SACHETSPHAROPHARMA40.00 EGP
ELECTRO MASH SYRUP 200 MLMASH PREMIERE60.00 EGP
FLEXOLYTE ORAL REHYDRATION SOL. 240 MLKEMPETRO FOR CHEMICAL INDUSTRIES65.00 EGP
HERO ORS 200 MLHERO > HERO MEA TRADING120.00 EGP
SANSO ORS SYRUP 140 MLAUG PHARMA400.00 EGP
2

REFERRAL & SAFETY-NETTING (NO DRUG THERAPY)

1st line
Dose source

Acute Gastroenteritis in Infants - disease-level clinical article (gastroenteritis-in-infants-clinical.txt)

Why

Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.

Cautions
  • RED FLAG - Hospitalization and IV fluids are indicated for severe dehydration or intractable vomiting.
3

ZINC SULFATE

add-on - not a substitute

Strength10 mg

Formoral.liquid

Adult dose and duration

Not applicable - pediatric entry x 10-14 days

Paediatric dose

(Infants <6 months: 10 mg elemental zinc once daily; Infants >=6 months and children: 20 mg once daily for 10-14 days)

Dose by age
Under 6 months:10 mg elemental zinc once daily
6 months and over:20 mg once daily for 10-14 days
Dose source

WHO/UNICEF IMCI Guidelines 2014

Why

WHO/UNICEF IMCI recommendation: zinc reduces duration and severity of infantile diarrhoea and prevents recurrence for 3 months

Cautions
  • Complete the full course - 10 to 14 days per WHO - even after the diarrhoea stops.
  • Egyptian products are zinc sulfate syrups, not the dispersible tablet the guideline describes. Give the stated milligram dose, measured from the strength printed on the bottle.
Egyptian brands
Egyptian brandManufacturerIndicative price
ZINC SULFATE 10MG/5ML POWDER FOR SYRUPCID5.00 EGP
SULFOZINC 10MG/5ML PD. FOR SUSP. 80MLCID22.00 EGP
ZINCOMIST 10MG/5ML SYRUP 120 MLORCHIDIA50.00 EGP
ZINC-SEDICO 10MG/5ML PD. FOR ORAL SOL.? strength differs? different route - not oral liquidSEDICO7.00 EGP
ZINC-SEDICO 20MG/5ML PD. FOR ORAL SOL.? strength differs? different route - not oral liquidSEDICO8.00 EGP
4

ONDANSETRON

add-on - not a substitute

Strength4 mg

Formoral.solid

Adult dose and duration

Not applicable - pediatric entry - single dose

Paediatric dose

0.15 mg/kg/dose [child max 4 mg]

(Single oral dose: 0.15 mg/kg (max 4 mg) for children >6 months with persistent vomiting preventing ORS)

Dose by weight
3kg0.45 mg/dose
4kg0.6 mg/dose
5kg0.75 mg/dose
6kg0.9 mg/dose
7kg1.1 mg/dose
8kg1.2 mg/dose
9kg1.3 mg/dose
10kg1.5 mg/dose
11kg1.6 mg/dose
12kg1.8 mg/dose
13kg1.9 mg/dose
14kg2.1 mg/dose
15kg2.2 mg/dose
16kg2.4 mg/dose
17kg2.5 mg/dose
18kg2.7 mg/dose
19kg2.9 mg/dose
20kg3 mg/dose
21kg3.1 mg/dose
22kg3.3 mg/dose
23kg3.4 mg/dose
24kg3.6 mg/dose
25kg3.8 mg/dose
26kg3.9 mg/dose
27kg4 mg/dose (capped)
28kg4 mg/dose (capped)
29kg4 mg/dose (capped)
30kg4 mg/dose (capped)
31kg4 mg/dose (capped)
32kg4 mg/dose (capped)
33kg4 mg/dose (capped)
34kg4 mg/dose (capped)
35kg4 mg/dose (capped)
36kg4 mg/dose (capped)
37kg4 mg/dose (capped)
38kg4 mg/dose (capped)
39kg4 mg/dose (capped)
40kg4 mg/dose (capped)
41kg4 mg/dose (capped)
42kg4 mg/dose (capped)
43kg4 mg/dose (capped)
44kg4 mg/dose (capped)
45kg4 mg/dose (capped)
46kg4 mg/dose (capped)
47kg4 mg/dose (capped)
48kg4 mg/dose (capped)
49kg4 mg/dose (capped)
50kg4 mg/dose (capped)
Dose source

ESPGHAN/ESPID Evidence-Based Guidelines for Acute Gastroenteritis in Children 2014 for the indication, with the figures from Egyptian National Drug Formulary - GIT medicines 2025, ondansetron monograph (endf-git.txt): "IV single dose: 0.15 mg/kg given immediately before chemotherapy (must not exceed 8 mg)" and "> 10 kg Up to 3 doses of 0.15 mg/kg IV every 4 hours 4 mg syrup or tablet every 12 hours". The formulary states those figures for chemotherapy-induced vomiting; the gastroenteritis indication is the ESPGHAN guideline's, which is not held in this corpus.

Why

Single oral dose enables successful oral rehydration in infants with severe vomiting avoiding IV access

Cautions
  • SINGLE DOSE ONLY: Repeated doses increase risk of diarrhoea recurrence and electrolyte shift.
  • Contraindicated in congenital long QT syndrome.
Egyptian brands
Egyptian brandManufacturerIndicative price
DANOFRAN 4MG 5 F.C. TAB.UP PHARMA70.00 EGP (14.00/unit)
SETRONOMET 4 MG 4 ORAL DIS. TABS.AVERROES PHARMA78.00 EGP
IDIVOMTRON 4 MG 10 ORALLY DIS. TABS.INTERNATIONAL DRUG AGENCY (IDI)144.00 EGP
EMEREST 4 MG 10 ORO-DISPERSIBLE TABS.GLOBAL PHARMACEUTICAL INDUSTRIES188.00 EGP
IDIVOMTRON 4 MG/5ML SYRUP 50 ML? strength differs? different route - not oral solidRAMEDA > INTERNATIONAL DRUG AGENCY (IDI)110.00 EGP

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.