N-Acetylcysteine treatment of rotavirus-associated diarrhea in children

Pharmacotherapy. 2014 Nov;34(11):e333-40. doi: 10.1002/phar.1489. Epub 2014 Sep 24.

Abstract

Rotaviruses are the leading cause of severe, acute, and dehydrating diarrhea affecting children under 5 years of age worldwide. Despite an important reduction in rotavirus-caused deaths as a consequence of the rotavirus vaccine, alternative or complementary strategies for preventing or treating rotavirus-associated diarrhea are needed mainly in the poorest countries. We describe the cases of four rotavirus-unvaccinated 12-13-month-old girls and a 5-year-old boy who developed rotavirus-associated diarrhea confirmed by enzyme-linked immunosorbent assay, Western blotting, and immunochemistry analyses. After the first day of diarrheal episodes, three of the five patients were immediately administered oral N-acetylcysteine (NAC) 60 mg/kg daily, divided into three equal doses every 8 hours. The other two patients did not receive NAC and served as controls. Administration of NAC resulted in a decreased number of diarrheal episodes, excretion of fecal rotavirus antigen, and resolution of symptoms after 2 days of treatment. Our results suggest that NAC treatment after the first diarrheal episode could be an efficient strategy for treating rotavirus-affected children and preventing the associated severe life-threatening accompanying dehydration.

Keywords: N-acetylcysteine treatment; gastrointestinal infection; rotavirus-associated diarrhea.

Publication types

  • Case Reports

MeSH terms

  • Acetylcysteine / administration & dosage
  • Acetylcysteine / therapeutic use*
  • Administration, Oral
  • Antiviral Agents / administration & dosage
  • Antiviral Agents / therapeutic use*
  • Child, Preschool
  • Colombia
  • Dehydration / etiology
  • Dehydration / prevention & control
  • Diarrhea / etiology
  • Diarrhea / physiopathology
  • Diarrhea / prevention & control*
  • Diarrhea, Infantile / etiology
  • Diarrhea, Infantile / physiopathology
  • Diarrhea, Infantile / prevention & control*
  • Female
  • Gastroenteritis / drug therapy*
  • Gastroenteritis / physiopathology
  • Gastroenteritis / virology
  • Humans
  • Infant
  • Male
  • Recurrence
  • Rotavirus Infections / drug therapy*
  • Rotavirus Infections / physiopathology
  • Rotavirus Infections / virology
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Antiviral Agents
  • Acetylcysteine