# Acute Gastroenteritis in Infants - Category: infectious - Review status: reviewed (every claim checked against a document named on this page) - 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 date: 2026-08 ## Verified against - 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) ## Treatment metadata - ORS — oral.liquid - Referral & safety-netting (no drug therapy) - Zinc sulfate — 10 mg — oral.liquid - Ondansetron — 4 mg — oral.solid ## Complete treatment card ```text ACUTE GASTROENTERITIS IN INFANTS 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 Review status: REVIEWED against 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) (2026-08) 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 Score WHO dehydration classification (child with diarrhoea) - How dehydrated is this child, and which rehydration plan? Source StatPearls "Viral Gastroenteritis" - disease-level clinical article Status traced to the source above 1. ORS [1st line] Adult Not applicable - pediatric entry x 3-5 days Peds 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. 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. Caution 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. Egypt GLUCOHYDRAN 10 SACHET. ARAB DRUG COM... 1.75 EGP REHYDRAN N 10 SACHET CID 4.50 EGP REHYDRO ZINC 10 SACHETS CID 7.00 EGP ORS 20 SACHETS PHAROPHARMA 40.00 EGP ELECTRO MASH SYRUP 200 ML MASH PREMIERE 60.00 EGP FLEXOLYTE ORAL REHYDRATION SOL. 240 ML KEMPETRO FOR CHEMICAL INDUSTRIES 65.00 EGP HERO ORS 200 ML HERO > HERO M... 120.00 EGP SANSO ORS SYRUP 140 ML AUG PHARMA 400.00 EGP 2. REFERRAL & SAFETY-NETTING (NO DRUG THERAPY) [1st line] Adult 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. Caution RED FLAG - Hospitalization and IV fluids are indicated for severe dehydration or intractable vomiting. 3. ZINC SULFATE [add-on - not a substitute] Adult Not applicable - pediatric entry x 10-14 days Peds Under 6 months: 10 mg elemental zinc once daily 6 months and over: 20 mg once daily for 10-14 days (Infants <6 months: 10 mg elemental zinc once daily; Infants >=6 months and children: 20 mg once daily for 10-14 days) 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 Caution 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. Egypt ZINC SULFATE 10MG/5ML POWDER FOR SYRUP CID 5.00 EGP SULFOZINC 10MG/5ML PD. FOR SUSP. 80ML CID 22.00 EGP ZINCOMIST 10MG/5ML SYRUP 120 ML ORCHIDIA 50.00 EGP ZINC-SEDICO 10MG/5ML PD. FOR ORAL SOL. SEDICO 7.00 EGP -> ? strength differs, ? different route - not oral liquid ZINC-SEDICO 20MG/5ML PD. FOR ORAL SOL. SEDICO 8.00 EGP -> ? strength differs, ? different route - not oral liquid 4. ONDANSETRON [add-on - not a substitute] Adult Not applicable - pediatric entry - single dose Peds 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) 3kg -> 0.45 mg/dose 4kg -> 0.6 mg/dose 5kg -> 0.75 mg/dose 6kg -> 0.9 mg/dose 7kg -> 1.1 mg/dose 8kg -> 1.2 mg/dose 9kg -> 1.3 mg/dose 10kg -> 1.5 mg/dose 11kg -> 1.6 mg/dose 12kg -> 1.8 mg/dose 13kg -> 1.9 mg/dose 14kg -> 2.1 mg/dose 15kg -> 2.2 mg/dose 16kg -> 2.4 mg/dose 17kg -> 2.5 mg/dose 18kg -> 2.7 mg/dose 19kg -> 2.9 mg/dose 20kg -> 3 mg/dose 21kg -> 3.1 mg/dose 22kg -> 3.3 mg/dose 23kg -> 3.4 mg/dose 24kg -> 3.6 mg/dose 25kg -> 3.8 mg/dose 26kg -> 3.9 mg/dose 27kg -> 4 mg/dose (capped) 28kg -> 4 mg/dose (capped) 29kg -> 4 mg/dose (capped) 30kg -> 4 mg/dose (capped) 31kg -> 4 mg/dose (capped) 32kg -> 4 mg/dose (capped) 33kg -> 4 mg/dose (capped) 34kg -> 4 mg/dose (capped) 35kg -> 4 mg/dose (capped) 36kg -> 4 mg/dose (capped) 37kg -> 4 mg/dose (capped) 38kg -> 4 mg/dose (capped) 39kg -> 4 mg/dose (capped) 40kg -> 4 mg/dose (capped) 41kg -> 4 mg/dose (capped) 42kg -> 4 mg/dose (capped) 43kg -> 4 mg/dose (capped) 44kg -> 4 mg/dose (capped) 45kg -> 4 mg/dose (capped) 46kg -> 4 mg/dose (capped) 47kg -> 4 mg/dose (capped) 48kg -> 4 mg/dose (capped) 49kg -> 4 mg/dose (capped) 50kg -> 4 mg/dose (capped) 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 Caution SINGLE DOSE ONLY: Repeated doses increase risk of diarrhoea recurrence and electrolyte shift. Contraindicated in congenital long QT syndrome. Egypt DANOFRAN 4MG 5 F.C. TAB. UP PHARMA 70.00 EGP (14.00/unit) SETRONOMET 4 MG 4 ORAL DIS. TABS. AVERROES PHARMA 78.00 EGP IDIVOMTRON 4 MG 10 ORALLY DIS. TABS. INTERNATIONAL DRUG AGENCY (IDI) 144.00 EGP EMEREST 4 MG 10 ORO-DISPERSIBLE TABS. GLOBAL PHARMACEUTICAL INDUSTRIES 188.00 EGP IDIVOMTRON 4 MG/5ML SYRUP 50 ML RAMEDA > INTE... 110.00 EGP -> ? strength differs, ? different route - not oral solid Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)