Treatment Guidance of Acute Diarrhea for Community Pharmacist
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Abstract
Acute diarrhea is a common disorder in drug store and an important problem which affects to public health system. Acute diarrhea may be caused by infectious and non-infectious causes. Acute diarrhea is classified severity of illness based on degree of dehydration as mild, moderate and severe. Community pharmacists have responsibility to provide pharmaceutical care for patients with acute diarrhea. The first step of pharmaceutical care should assess the medical history, symptom severity and causes of diarrhea to consider about treatment settings of patients between drug store or referral to hospital. Selection of medications should be based on efficacy, safety and cost to provide appropriate treatment for individual patient. Pharmacotherapy of acute diarrhea should focus on 1) appropriate use of oral rehydration therapy, 2) appropriate use of antidiarrheal drugs such as loperamide, racecadotril, diosmectite and probiotics in patients with variety of medical conditions. Loperamide should be used with caution in patients with cardiovascular disease, elderly patients and children particularly young children because loperamide has contraindication in children < 2 years, 3) Consideration of antibiotics for treatment of acute diarrhea. There is a very high rate of overuse of antibiotics in drug store and hospital which lead to increase risk of antimicrobial resistance and risk of adverse events. Therefore, appropriate use of antibiotics is an important issue to prevent these problems.
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