Effects of loperamide on fecal electrolyte excretion in acute diarrhea in infants

: The effect of loperamide (Imodium) on fecal excretion of electrolytes was studied using a double-blind protocol in 63 infants aged 1 to 32 months, presenting with acute diarrhea. The etiology of these infections was due to virus (n = 9), E. coli (n = 4), Salmonella (n = 4), Shigella (n = 2) or was of undetermined origin (n = 34). The therapeutic protocol was the same for all the infants: ad libitum oral rehydration, with no drug being administered except for Imodium at an average dose of 20 to 25 drops/kg/24 h (0.16 to 0.20 mg/kg/24 h), given every 8 hours for at least 48 hours. Stool Na+ and K+ concentrations were determined in samples taken before and after the double-blind trial. In patients receiving loperamide, we observed a non-significant decrease in fecal Na+ concentration as compared with values before treatment. Comparison of the two groups of infants, one receiving Imodium, the other a placebo, showed a significant difference (p less than 1%) in fecal sodium concentration, due rather to an increase in stool Na+ in the placebo group than to a decrease in the group treated with Imodium. Moreover, the use of loperamide, compared with the placebo, did not result in a significant decrease in the number of stools, modified fecal K+ values, or more rapid recovery from the diarrheal syndrome.