What is the recommended dose of Econorm (anti-diarrheal medication) for a child with diarrhea?

Econorm Dosing for Pediatric Diarrhea

The evidence provided does not contain specific dosing information for Econorm (Saccharomyces boulardii), but probiotics may be offered to reduce symptom severity and duration in immunocompetent children with infectious diarrhea, with specific dosing recommendations found through manufacturer guidance. 1

Primary Treatment: Oral Rehydration Solution (ORS)

The cornerstone of diarrhea management in children is oral rehydration therapy, not probiotics or other adjunctive agents. 2 The following algorithm should guide your approach:

Step 1: Assess Dehydration Severity

Examine the child for: 1, 2

• Skin turgor and capillary refill time (most reliable predictor) 3
• Mucous membrane moisture
• Mental status
• Pulse quality
• Weight loss (most reliable clinical indicator) 4

Classify as: 1, 2

• Mild: 3-5% fluid deficit
• Moderate: 6-9% fluid deficit
• Severe: ≥10% fluid deficit with shock/near-shock

Step 2: Rehydration Protocol

For mild dehydration: Administer 50 mL/kg of ORS over 2-4 hours 1, 2

For moderate dehydration: Administer 100 mL/kg of ORS over 2-4 hours 1, 2

For severe dehydration: Immediate IV rehydration with 20 mL/kg boluses of Ringer's lactate or normal saline until pulse, perfusion, and mental status normalize, then transition to ORS 1, 2

Step 3: Managing Vomiting

If the child is vomiting, administer 5-10 mL of ORS every 1-2 minutes using a spoon or syringe, gradually increasing volume as tolerated. 2, 4 A common pitfall is allowing a thirsty child to drink large volumes rapidly, which worsens vomiting. 2

Step 4: Replace Ongoing Losses

Administer 10 mL/kg of ORS for each watery stool and 2 mL/kg for each vomiting episode. 1, 2, 4

Adjunctive Therapies (After Rehydration)

Probiotics (Including Econorm)

Probiotic preparations may be offered to reduce symptom severity and duration in immunocompetent children with infectious diarrhea. 1 However, the guidelines explicitly state that specific recommendations regarding selection of probiotic organism(s), route of delivery, and dosage should be found through literature searches and manufacturer guidance. 1

For Econorm specifically, you must consult the manufacturer's package insert for age-appropriate dosing, as this information is not standardized in clinical guidelines. 1

Zinc Supplementation

Oral zinc supplementation reduces diarrhea duration in children 6 months to 5 years of age who reside in countries with high zinc deficiency prevalence or show signs of malnutrition. 1, 2

Ondansetron

May be given to children >4 years of age to facilitate oral rehydration when vomiting is present, but only after adequate hydration is achieved. 1, 2

Critical Contraindications

Antimotility drugs (loperamide) are absolutely contraindicated in all children <18 years of age. 1, 2 This is a strong recommendation with moderate-quality evidence. 1

Nutritional Management

• Continue breastfeeding on demand throughout the entire diarrheal episode without interruption. 2, 4
• Resume age-appropriate diet during or immediately after rehydration is completed. 1, 2
• Include starches, cereals, yogurt, fruits, and vegetables. 2

When to Seek Immediate Medical Attention

Return immediately if: 4, 3

• Bloody diarrhea develops
• Persistent watery stools continue
• Intractable vomiting occurs
• Decreased urine output
• Lethargy or irritability
• High stool output (>10 mL/kg/hour)

Key Clinical Pitfall

The most common error is prioritizing probiotics or other adjunctive agents over adequate fluid replacement. ORS is the evidence-based cornerstone of treatment, with probiotics playing only a supplementary role. 1, 2 Always ensure proper rehydration before considering any adjunctive therapy.