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Is Nor-metrogyl Advisable For Severe Diarrhea In A Toddler?

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Posted on Mon, 29 Jun 2015
Question: Hi, my son 4 yrs , 10 months (weight 18 kg) has been having watery motions since 4 days (at least 6-8 times day). Doctor has prescribed ziprax 100. But it is not stopping. Another family friend who is in medical profession suggested nor-metrogyl. Just wanted to check if its ok to switch medicines. If so what should be dosage.

Regards,

XXXX
doctor
Answered by Dr. Tushar Kanti Biswas (51 minutes later)
Brief Answer:
Diarrhoea in child

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.
Since Ziprax (Cefixime)100mg is not working ,you should switch over to some other antibiotic as causative organism may be resistant to Cefixime.Nor-metrogyl contains norfloxacin and metronidazole.
The cornerstone of diagnosis in those suspected of severe acute infectious diarrhea is microbiologic analysis of the stool.
Workup includes cultures for bacterial and viral pathogens, direct inspection for ova and parasites, and immunoassays for certain bacterial toxins (C. difficile), viral antigens (rotavirus), and protozoal antigens (Giardia, E. histolytica).

However many physicians treat moderately to severely ill patients with diarrhoea empirically without diagnostic evaluation using a quinolone, such as ciprofloxacin or norfloxacin.
Moreover many cases of diarrhoea is due to mixed infection i.e. by bacteria and amoeba(E. histolytica) or Giardia.
Empirical treatment can also be considered for suspected giardiasis/amebiasis with metronidazole .
However safety and efficacy of quinolone, such as ciprofloxacin or norfloxacin. is not established (oral form) in children-hence cannot be recommended.
Metronidazole dose-child 3-7 years-half the adult dose of 400 mg three times a day for 5 days for amebiasis only.
Many cases of diarrhea is viral and self-limiting and oral re hydration solution is all that needed for fluid and electrolyte losses.
Dr. T.K. Biswas M.D. XXXXXXX
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Answered by
Dr.
Dr. Tushar Kanti Biswas

Internal Medicine Specialist

Practicing since :1975

Answered : 1920 Questions

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Is Nor-metrogyl Advisable For Severe Diarrhea In A Toddler?

Brief Answer: Diarrhoea in child Detailed Answer: Hi, Thank you for your query. I can understand your concerns. Since Ziprax (Cefixime)100mg is not working ,you should switch over to some other antibiotic as causative organism may be resistant to Cefixime.Nor-metrogyl contains norfloxacin and metronidazole. The cornerstone of diagnosis in those suspected of severe acute infectious diarrhea is microbiologic analysis of the stool. Workup includes cultures for bacterial and viral pathogens, direct inspection for ova and parasites, and immunoassays for certain bacterial toxins (C. difficile), viral antigens (rotavirus), and protozoal antigens (Giardia, E. histolytica). However many physicians treat moderately to severely ill patients with diarrhoea empirically without diagnostic evaluation using a quinolone, such as ciprofloxacin or norfloxacin. Moreover many cases of diarrhoea is due to mixed infection i.e. by bacteria and amoeba(E. histolytica) or Giardia. Empirical treatment can also be considered for suspected giardiasis/amebiasis with metronidazole . However safety and efficacy of quinolone, such as ciprofloxacin or norfloxacin. is not established (oral form) in children-hence cannot be recommended. Metronidazole dose-child 3-7 years-half the adult dose of 400 mg three times a day for 5 days for amebiasis only. Many cases of diarrhea is viral and self-limiting and oral re hydration solution is all that needed for fluid and electrolyte losses. Dr. T.K. Biswas M.D. XXXXXXX