Comparative clinical trial of acceptability of flavoured vs non-flavoured ORS (WHO formula).

The acceptability and effectiveness of flavored versus unflavored oral rehydration salts (ORS) were investigated in a prospective study involving 112 children 1-24 months of age treated at Karachis National Institute of Child Health for mild to moderate diarrhea-associated dehydration. The 56 children in Group A received the standard WHO ORS formula while the 56 children in Group B received the WHO preparation flavored with a lemon-lime agent. If either of the solutions was refused 3 consecutive times the alternate formulation was offered. The average amount of ORS consumed before rehydration was achieved was 350 ml in Group A and 372.3 ml in Group B while the average time taken for rehydration was 3.14 hours in Group A and 3.09 hours in Group B. Acceptability was good (defined as ingestion of 70-100% of the required amount) during the initial rehydration period in 85.7% of children in Group A and 87.5% of those in Group B. During the maintenance period however a marked preference was manifested for the flavored solution which was consumed in significantly greater quantities. A disadvantage of this preference was the greater incidence of overhydration in Group B (19.6% versus 3.6% in Group A) in the maintenance period; another disadvantage was the fact that 21.2% of children in Group B compared with only 8.2% of those in Group A were hypernatremic after 24 hours. Overall these findings suggest that while flavored ORS can be used during the initial rehydration period the unflavored solution is a safer maintenance therapy.