Evidence-based guidelines for the management of acute gastroenteritis in children in Europe:executive summmary

Acute gastroenteritis (AGE) is one of the most common diseases in children, and the second leading cause of morbidity and mortality worldwide. All children are expected to experience AGE in the first 3 years of life. The attack rate ranges from 0.5 to 1.9 illnesses per person annually in high-income countries, and is higher in the first 2 to 3 years of life (2.5 illnesses per child per year to even 5 illnesses in those attending day care centers) (1). In most European countries AGE is usually a mild disease, but it is still associated with a large number of hospital admissions and a not negligible number of deaths (2). Europe encompasses a large number of wealthy and less wealthy countries that differ in tradition, culture, and health care systems. New options in terms of diagnosis, nutritional interventions, drugs, and now vaccines, are becoming available and may affect the severity and duration of symptoms as well as reduce the infection rate. Clinical practice guidelines are one of the tools that help the practitioner keep up to date and identify the best practices. A number of guidelines for the management of children with AGE are available (3–5). Nevertheless, there appears to be considerable clinical variation in the management of AGE across Europe (6). This may reflect a degree of uncertainty as to which treatments are most useful, who would benefit from treatment and which treatments will result in cost-effective health gain. Furthermore, there is often a gap between the research identifying an effective clinical practice and its widespread adoption. In this scenario, the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) and the European Society for Paediatric Infectious Diseases (ESPID) joined forces to develop 2 parallel recommendations/guideline papers, 1 devoted to the clinical management of the otherwise healthy child with AGE and the other to rotavirus vaccination.