A single oral rehydration solution for global use?(Current Topics)

Diarrhoeal diseases remain important causes of death and morbidity in developing countries, with an estimated 1.5 billion episodes and 1.5 million to 2.5 million deaths each year among children younger than 5 years (1-4). A critical factor in reducing diarrhoeal deaths has been the widespread adoption of oral rehydration solution (ORS) programmes for the treatment and prevention of diarrhoea-associated dehydration (5, 6). An article recently appearing in the Journal of the American Medical Association (7) has proposed that the composition of oral rehydration solution is now in need of a revision and proposes the following argument.

The composition of oral rehydration solution has proven to be both safe and effective in worldwide use, based on its efficacy in replacing water and electrolytes in individuals with cholera infection. However, concern that the sodium concentration of 90 mEq/L was too high for the lower salt losses of viral and other causes of childhood diarrhoea (8) was invoked to explain its low acceptance among paediatricians in industrialized …