Guideline for managing acute diarrhea in the context of pharmaceutical care

Abstract

Objective: To systematize, through evidence-based practice, the management of self-limited cases of acute diarrhea in the context of Pharmaceutical Care. Methods: To prepare the guideline, the ADAPTE method was adopted as a structured process of literature review and document construction. The AGREE II and GRADE tools were also used to analyze the practice guides selected during the process and to categorize the evidence, respectively. Results: After elaboration, it was observed that the pharmaceutical anamnesis is an important step in confirming the self-limiting nature of acute diarrhea, preventing acute viral gastroenteritis and referral when warning signs such as severe dehydration or associated symptoms are suspected. Non-pharmacological measures were generally strongly recommended. Oral rehydration therapy and continuous breastfeeding in infants show high levels of evidence. Regarding pharmacological measures, as an adjunct to rehydration therapy, there is first-line treatment, which includes over-the-counter medicines, and second-line treatment, which consists of treatment with antidiarrheals, antisecretory agents, antibiotics and antiparasitic drugs. The pharmacist must be attentive and trained to observe and monitor the appearance of warning signs for referral such as dysentery, persistent diarrhea, severe dehydration, drug-induced diarrhea, diarrhea in risk groups, diarrhea due to a potential infectious outbreak and/or associated symptoms.