Can Pedialyte (electrolyte solution) be prescribed to adults?

Can Pedialyte Be Prescribed to Adults?

Yes, Pedialyte (oral rehydration solution) can be prescribed and is effective for adults with dehydration from acute diarrhea and other causes. 1, 2

Evidence for Adult Use

Reduced osmolarity oral rehydration solution (ORS) is recommended as first-line therapy for mild to moderate dehydration in adults with acute diarrhea from any cause. 1 This guideline from the Infectious Diseases Society of America (2017) explicitly includes adults in its recommendations for ORS use, making no distinction between pediatric and adult populations for this indication. 1

Clinical Trial Evidence in Adults

A randomized controlled trial specifically examined Pedialyte in adult patients with viral gastroenteritis and found it to be effective and safe. 2 In this study of 75 consecutive adult patients:

• Pedialyte successfully corrected dehydration in adults with viral gastroenteritis 2
• Stool frequency, consistency, and body weight improved significantly (p < .001) 2
• The solution was safe, with minimal electrolyte disturbances (hypokalemia in 2 patients at admission, 2 at 24 hours, and 1 at 48 hours; hyponatremia in 4,5, and 4 patients respectively) 2
• Pedialyte performed comparably to other rehydration solutions in correcting dehydration and improving bowel symptoms 2

When to Use ORS in Adults

ORS should be administered for mild to moderate dehydration in adults until clinical dehydration is corrected. 1 Specific indications include:

• Acute diarrhea with mild to moderate dehydration 1
• Dehydration associated with vomiting or severe diarrhea 1
• Volume depletion states 3

When to Escalate to Intravenous Therapy

Isotonic intravenous fluids (lactated Ringer's or normal saline) should be administered when there is severe dehydration, shock, altered mental status, or failure of ORS therapy. 1, 3 Additional indications for IV fluids include:

• Ileus preventing oral intake 1
• Serum osmolality >300 mOsm/kg in patients who appear unwell 3
• Ketonemia requiring initial IV hydration to enable tolerance of oral rehydration 1

Practical Considerations

Palatability Issues

One important caveat: Pedialyte was rated lower in taste preference compared to Gatorade and other solutions in adult studies (p < .05). 2 This may affect compliance, though efficacy remains equivalent. 2

Maintenance Therapy

Once rehydrated, maintenance fluids should be administered using ORS to replace ongoing losses until diarrhea and vomiting resolve. 1 Age-appropriate diet should be resumed during or immediately after rehydration. 1

Monitoring

Hydration status should be reassessed regularly until corrected, then monitored periodically. 3 Serum osmolality <275 mOsm/kg indicates hyposmolality and requires evaluation. 3

Common Pitfalls to Avoid

• Do not withhold ORS in favor of IV therapy for mild-moderate dehydration - ORS is first-line and equally effective 1
• Do not use antimotility drugs as a substitute for fluid and electrolyte therapy - these are only ancillary treatments after adequate hydration 1
• Do not rely solely on clinical signs like skin turgor to assess hydration status - serum osmolality is the primary indicator 3