ОСТРАЯ ДИАРЕЯ У ВЗРОСЛЫХ: АКТУАЛЬНОСТЬ ПРОБЛЕМЫ И НОВЫЕ ВОЗМОЖНОСТИ ТЕРАПИИ

1. Riddle M.S., DuPont H.L., Connor B.A. ACG Clinical Guideline: diagnosis,
treatment, and prevention of acute diarrheal infections in adults //
Am. J. Gastroenterol. 2016. Vol. 111, N 5. P. 602–622.
2. Guarino A., Albano F., Ashkenazi S. et al. European Society for Paediatric
Gastroenterology, Hepatology, and Nutrition/European Society for
Paediatric Infectious Diseases evidence-based guidelines for the management
of acute gastroenteritis in children in Europe // J. Pediatr. Gastroenterol.
Nutr. 2008. Vol. 46, suppl. 2. P. S81—S122.
3. Baldi F., Bianco M.A., Nardone G., Pilotto A. et al. Focus on acute diarrhoeal
disease // World J. Gastroenterol. 2009. Vol. 15, N 27. P. 3341–3348.
4. Manatsathit S., Dupont H.L., Farthing M. et al. Guideline for the
management of acute diarrhea in adults // J. Gastroenterol. Hepatol.
2002. Vol. 17, suppl. P. S54—S71.
5. Ко­жу­хо­ва Е.А., Ан­дре­ева Н.В., Ива­щен­ко В.Д. Этап­ный ана­лиз
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April 2013. URL: http://www.who.int/mediacentre/factsheets/fs330/en/
7. Vos T., Barber R.M., Bell B. et al. Global, regional, and national incidence,
prevalence, and years lived with disability for 301 acute and chronic
diseases and injuries in 188 countries, 1990–2013: a systematic analysis for
the Global Burden of Disease Study 2013 // Lancet. 2015. Vol. 386, N 9995.
P. 743–800.
8. Soffer E.E. Diarrhea // Cecil Essentials of Medicine. 5th ed. / eds
T.E. Andreoli, C.C.J. Carpenter, R. Griggs, J. Loscalzo. Philadelphia, PA :
W.B. Saunders, 2001. P. 316–320.
9. Фе­де­раль­ная служ­ба го­судар­ствен­ной ста­ти­сти­ки. За­боле­ва­е­мость на­се­ле­ния от­дель­ны­ми ин­фек­ци­он­ны­ми за­боле­ва­ни­я­ми в 2016
го­ду (дан­ные Ро­спо­треб­над­зо­ра). URL: http://www.gks.ru/bgd/regl/
b17_01/IssWWW.exe/Stg/d01/3-3.doc
10. Lamberti L.M., Fischer Walker C.L., Black R.E. Systematic review
of diarrhea duration and severity in children and adults in low- and middleincome
countries // BMC Public Health. 2012. Vol. 12. P. 276.
11. Naghavi M., Wang H., Lozano R. et al. Global, regional, and national
age-sex specific all-cause and cause-specific mortality for 240 causes
of death, 1990-2013: a systematic analysis for the Global Burden of Disease
Study 2013 // Lancet. 2015. Vol. 385, N 9963. P. 117–171.
12. Kosek M., Bern C., Guerrant R.L. The global burden of diarrhoeal
disease, as estimated from studies published between 1992 and 2000 //
Bull. World Health Organ. 2003. Vol. 81, N 3. P. 197–204.
13. Gangarosa R.E., Glass R.I., Lew J.F., Boring J.R. Hospitalizations involving
gastroenteritis in the United States, 1985 the special burden of the
disease among the elderly // Am. J. Epidemiol. 1992. Vol. 135. P. 281–290.
14. Фе­де­раль­ная служ­ба го­судар­ствен­ной ста­ти­сти­ки. Све­де­ния
о смерт­но­сти на­се­ле­ния по при­чи­нам смер­ти по Рос­сий­ской Фе­де­ра­ции
(за ян­варь — де­кабрь 2016 го­да). URL: http://gks.ru/free_doc/2016/
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15. Thielman N.M., Guerrant R.L. Clinical practice. Acute infectious
diarrhea // N. Engl. J. Med. 2004. Vol. 350. P. 38–47.
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J. Antimicrob. Agents. 2000. Vol. 14, N 1. P. 65–69.
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диа­рей : ав­то­реф. дис. … д-ра мед. на­ук. М., 2009. 45 с.
19. Farthing M.J. Antisecretory drugs for diarrheal disease // Dig. Dis.
2006. Vol. 24, N 1–2. P. 47–58.
20. Victora C.G., Bryce J., Fontaine O., Monasch R. Reducing deaths
from diarrhoea through oral rehydration therapy // Bull. World Health
Organ. 2000. Vol. 78, N 10. P. 1246–1255.
21. Garthright W.E., Archer D.L., Kvenberg J.E. Estimates of incidence
and costs of intestinal infectious diseases in the United States // Public
Health Rep. 1988. Vol. 103, N 2. P. 107–115.
22. Lew J.F., Glass R.I., Gangarosa R.E., Cohen I.P. et al. Diarrheal
deaths in the United States, 1979 through 1987. A special problem for the
elderly // JAMA. 1991. Vol. 265, N 24. P. 3280–3284.
23. Bennett R.G., Greenough W.B. 3rd. Approach to acute diarrhea in
the elderly // Gastroenterol. Clin. North Am. 1993. Vol. 22, N 3. P. 517–533.
24. Sur D., Bhattacharya S.K. Acute diarrhoeal diseases — an approach
to management // J. Indian Med. Assoc. 2006. Vol. 104, N 5. P. 220—
223.
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26. Schiller L.R., Santa Ana C.A., Morawski S.G., Fordtran J.S. Mechanism
of the antidiarrheal effect of loperamide // Gastroenterology. 1984.
Vol. 86, N 6. P. 1475–1480.
27. Douma J.A., Smulders Y.M. Loperamide for acute infectious diarrhoea
// Ned. Tijdschr. Geneeskd. 2015. Vol. 159. Article ID A9132.
28. Nelson J.M., Griffin P.M., Jones T.F., Smith K.E. et al. Antimicrobial
and antimotility agent use in persons with shiga toxin-producing
Escherichia coli O157 infection in FoodNet Sites // Clin. Infect. Dis. 2011.
Vol. 52, N 9. P. 1130–1132.
29. U.S. Food and Drug Administration. Loperamide, 2015. URL:
http://www.drugs.com/pro/loperamide.html.
30. Rang H.P., Dale M.M., Ritter J.M., Flower R.J. et al. Rang and Dale’s
Pharmacology. London : Elsevier; Churchill Livingstone, 2012.
31. Kreisl W.C., Liow J.S., Kimura N., Seneca N. et al. P-glycoprotein
function at the blood-brain barrier in humans can be quantified with the
substrate radiotracer 11 C-N-desmethyl-loperamide // J. Nucl. Med. 2010.
Vol. 51, N 4. P. 559–566. doi: 10.2967/jnumed.109.070151.
32. U.S. Food and Drug Administration. FDA Drug Safety Communication:
FDA Warns about Serious Heart Problems with High Doses
of the Antidiarrheal Medicine Loperamide (Imodium), Including from
Abuse and Misuse, 2016. URL: http://www.fda.gov/Drugs/DrugSafety/
ucm504617.htm
33. Sebastian Domingo J.J. Review of the role of probiotics in gastrointestinal
diseases in adults // Gastroenterol. Hepatol. 2017. Vol. 40,
N 6. P. 417–429.
34. Chang F.Y., Lu C.L., Chen C.Y., Luo J.C. Efficacy of dioctahedral
smectite in treating patients of diarrhea-predominant irritable bowel syndrome
// J. Gastroenterol. Hepatol. 2007. Vol. 22, N 12. P. 2266–2272.
35. Yao-Zong Y., Shi-Rong L., Delvaux M. Comparative efficacy of dioctahedral
smectite (Smecta) and a probiotic preparation in chronic functional
diarrhea // Dig. Liver Dis. 2004. Vol. 36, N 12. P. 824–828.
36. Matheson A.J., Noble S. Racecadotril // Drugs. 2000. Vol. 59, N 4.
P. 829–835.
37. Schwartz J.C. Racecadotril: a new approach to the treatment
of diarrhoea // Int. J. Antimicrob. Agents. 2000. Vol. 14, N 1. P. 75–79.
38. Racecadotril. Abbott scientific brochure (data on file).
39. Fischbach W., Andresen V., Eberlin M., Mueck T. et al. A comprehensive
comparison of the efficacy and tolerability of racecadotril with other
treatments of acute diarrhea in adults // Front. Med. (Lausanne). 2016. Vol. 3.
P. 44.
40. Baumer P., Dorval E.D., Bertrand J., Vetel J.M. et al. Effects of acetorphan,
an enkephalinase inhibitor, on experimental and acute diarrhea //
Gut. 1992. Vol. 33. P. 753–758.
41. Hamza H., Ben K.H., Baumer P., Berard H. et al. Racecadotril versus
placebo in the treatment of acute diarrhea in adults // Aliment. Pharmacol.
Ther. 1999. Vol. 13, suppl. 6. P. 15–19.
42. Vetel J.M., Hamza H., Coffin B., Lehert P. Racecadotril efficacy
in the symptomatic treatment of adult acute diarrhoea: a systematic review
and meta-analysis // Int. J. Clin. Med. 2014. Vol. 5. P. 361–375.
43. Coffin B., Hamza H., Vetel J.M., Lehert P. Racecadotril in the treatment
of acute diarrhoea in adults. An individual patient data based metaanalysis
// Int. J. Clin. Med. 2014. Vol. 5. P. 345–360.
44. Roge J., Baumer P., Berard H., Schwartz J.C. et al. The enkephalinase
inhibitor, acetorphan, in acute diarrhoea. A double-blind, controlled clinical
trial versus loperamide // Scand. J. Gastroenterol. 1993. Vol. 28. P. 352–354.
45. Vetel J.M., Berard H., Fretault N., Lecomte J.M. Comparison
of racecadotril and loperamide in adults with acute diarrhoea // Aliment.
Pharmacol. Ther. 1999. Vol. 13, suppl. 6. P. 21–26.
46. Prado D. A multinational comparison of racecadotril and loperamide
in the treatment of acute watery diarrhoea in adults // Scand.
J. Gastroenterol. 2002. Vol. 37, N 6. P. 656–661.
47. Gallelli L., Colosimo M., Tolotta G.A. et al. Prospective randomized
double-blind trial of racecadotril compared with loperamide in elderly
people with gastroenteritis living in nursing homes // Eur. J. Clin. Pharmacol.
2010. Vol. 66. P. 137–144.
48. Moraes E., Chinzon D., Coleho L.G., Fernandes T.F. et al. A multicentric,
randomised, investigator-blinded, parallel group study to assess
the efficacy, safety and tolerability of racecadotril versus Saccharomyces
boulardii in the treatment of acute diarrhea in adults // Rev. Bras. Med.
2001. Vol. 58, N 1–2. P. 65–74.

1. Riddle M.S., DuPont H.L., Connor B.A. ACG Clinical Guideline: diagnosis,
treatment, and prevention of acute diarrheal infections in adults. Am
J Gastroenterol. 2016; 111 (5): 602–22.
2. Guarino A., Albano F., Ashkenazi S., et al. European Society for Paediatric
Gastroenterology, Hepatology, and Nutrition/European Society for
Paediatric Infectious Diseases evidence-based guidelines for the management
of acute gastroenteritis in children in Europe. J Pediatr Gastroenterol
Nutr. 2008; 46 (suppl. 2): S81—122.
3. Baldi F., Bianco M.A., Nardone G., Pilotto A., et al. Focus on acute
diarrhoeal disease. World J Gastroenterol. 2009; 15 (27): 3341–8.
4. Manatsathit S., Dupont H.L., Farthing M., et al. Guideline for the
management of acute diarrhea in adults. J Gastroenterol Hepatol. 2002;
17 (suppl.): S54—71.
5. Kozhukhova E.A., Andreeva N.V., Ivashchenko V.D. Open ended results
of acute diarrhea agent detection to verify diagnosis in adult cases.
Infektsiya i immunitet [Infection and Immunity]. 2016; (4): 379–83.
(in Russian)
6. Diarrhoeal disease. Fact sheet No.°330. World Health Organization,
April 2013. URL: http://www.who.int/mediacentre/factsheets/fs330/en/
7. Vos T., Barber R.M., Bell B. et al. Global, regional, and national incidence,
prevalence, and years lived with disability for 301 acute and chronic
diseases and injuries in 188 countries, 1990–2013: a systematic analysis for
the Global Burden of Disease Study 2013. Lancet. 2015; 386 (9995): 743–800.
8. Soffer E.E. Diarrhea. Cecil Essentials of Medicine. 5th ed. Eds
T.E. Andreoli, C.C.J. Carpenter, R. Griggs, J. Loscalzo. Philadelphia, PA:
W.B. Saunders; 2001: 316–20.
9. Federal Service of State Statistics. Morbidity of the population by certain
infectious diseases in 2016 (data from Rospotrebnadzor). URL: http://
www.gks.ru/bgd/regl/b17_01/IssWWW.exe/Stg/d01/3-3.doc (in Russian)
10. Lamberti L.M., Fischer Walker C.L., Black R.E. Systematic review
of diarrhea duration and severity in children and adults in low- and middleincome
countries. BMC Public Health. 2012; 12: 276.
11. Naghavi M., Wang H., Lozano R., et al. Global, regional, and national
age-sex specific all-cause and cause-specific mortality for 240
causes of death, 1990-2013: a systematic analysis for the Global Burden of
Disease Study 2013. Lancet. 2015; 385 (9963): 117–71.
12. Kosek M., Bern C., Guerrant R.L. The global burden of diarrhoeal
disease, as estimated from studies published between 1992 and 2000. Bull
World Health Organ. 2003; 81 (3): 197–204.
13. Gangarosa R.E., Glass R.I., Lew J.F., Boring J.R. Hospitalizations
involving gastroenteritis in the United States, 1985 the special burden
of the disease among the elderly. Am J Epidemiol. 1992; 135: 281–90.
14. Federal Service of State Statistics. Data on the death rate of the
population for reasons of death in the Russian Federation (January—December
2016). URL: http://gks.ru/free_doc/2016/demo/t3_3.xls. (in Russian)
15. Thielman N.M., Guerrant R.L. Clinical practice. Acute infectious
diarrhea. N Engl J Med. 2004; 350: 38–47.
16. Yushchuk N.D., Martynov Yu.V., Kulagina M.G. Ostrye kishechnye
infektsii [Acute Intestinal Infections]. 2nd. Мoscow; 2012: 402 p. (in Russian)
17. Farthing M.J. Diarrhoea: a significant worldwide problem. Int
J Antimicrob. Agents. 2000; 14 (1): 65–9.
18. Gyulazyan N.M. Clinical and pathogenetic significance of bacterial
toxins in the development of the characteristics of the course of acute intestinal
diarrhea: Abstract of Diss. Мoscow; 2009: 45 p. (in Russian)
19. Farthing M.J. Antisecretory drugs for diarrheal disease. Dig Dis.
2006; 24 (1–2): 47–58.
20. Victora C.G., Bryce J., Fontaine O., Monasch R. Reducing deaths
from diarrhoea through oral rehydration therapy. Bull World Health Organ.
2000; 78 (10): 1246–55.
21. Garthright W.E., Archer D.L., Kvenberg J.E. Estimates of incidence
and costs of intestinal infectious diseases in the United States. Public
Health Rep. 1988; 103 (2): 107–15.
22. Lew J.F., Glass R.I., Gangarosa R.E., Cohen I.P., et al. Diarrheal
deaths in the United States, 1979 through 1987. A special problem for the
elderly. JAMA. 1991; 265 (24): 3280–4.
23. Bennett R.G., Greenough W.B. 3rd. Approach to acute diarrhea
in the elderly. Gastroenterol Clin North Am. 1993; 22 (3): 517–33.
24. Sur D., Bhattacharya S.K. Acute diarrhoeal diseases — an approach
to management. J Indian Med Assoc. 2006; 104 (5): 220–3.
25. Federal Guidelines for the Use of Medicines (Formulary System).
Is. ХVIII. Мoscow : Vidoks; 2017: 848 p. (in Russian)
26. Schiller L.R., Santa Ana C.A., Morawski S.G., Fordtran J.S. Mechanism
of the antidiarrheal effect of loperamide. Gastroenterology. 1984;
86 (6): 1475–80.
27. Douma J.A., Smulders Y.M. Loperamide for acute infectious diarrhea.
Ned Tijdschr Geneeskd. 2015; 159: ID A9132.
28. Nelson J.M., Griffin P.M., Jones T.F., Smith K.E., et al. Antimicrobial
and antimotility agent use in persons with shiga toxin-producing Escherichia
coli O157 infection in FoodNet Sites. Clin Infect Dis. 2011; 52 (9):
1130–2.
29. U.S. Food and Drug Administration. Loperamide, 2015.
URL: http://www.drugs.com/pro/loperamide.html.
30. Rang H.P., Dale M.M., Ritter J.M., Flower R.J., et al. Rang and Dale’s
Pharmacology. London : Elsevier; Churchill Livingstone; 2012.
31. Kreisl W.C., Liow J.S., Kimura N., Seneca N., et al. P-glycoprotein
function at the blood-brain barrier in humans can be quantified with the
substrate radiotracer 11 C-N-desmethyl-loperamide. J Nucl Med. 2010;
51 (4): 559–66. doi: 10.2967/jnumed.109.070151.
32. U.S. Food and Drug Administration. FDA Drug Safety Communication:
FDA Warns about Serious Heart Problems with High Doses of the
Antidiarrheal Medicine Loperamide (Imodium), Including from Abuse and
Misuse, 2016. URL: http://www.fda.gov/Drugs/DrugSafety/ucm504617.
htm
33. Sebastian Domingo J.J. Review of the role of probiotics in gastrointestinal
diseases in adults. Gastroenterol Hepatol. 2017; 40 (6): 417–29.
34. Chang F.Y., Lu C.L., Chen C.Y., Luo J.C. Efficacy of dioctahedral
smectite in treating patients of diarrhea-predominant irritable bowel syndrome.
J Gastroenterol Hepatol. 2007; 22 (12): 2266–72.
35. Yao-Zong Y., Shi-Rong L., Delvaux M. Comparative efficacy of dioctahedral
smectite (Smecta) and a probiotic preparation in chronic functional
diarrhea. Dig Liver Dis. 2004; 36 (12): 824–8.
36. Matheson A.J., Noble S. Racecadotril. Drugs. 2000; 59 (4):
829–35.
37. Schwartz J.C. Racecadotril: a new approach to the treatment
of diarrhea. Int J Antimicrob. Agents. 2000; 14 (1): 75–9.
38. Racecadotril. Abbott scientific brochure (data on file).
39. Fischbach W., Andresen V., Eberlin M., Mueck T., et al. A comprehensive
comparison of the efficacy and tolerability of racecadotril with
other treatments of acute diarrhea in adults. Front Med (Lausanne).
2016; 3: 44.
40. Baumer P., Dorval E.D., Bertrand J., Vetel J.M. et al. Effects of acetorphan,
an enkephalinase inhibitor, on experimental and acute diarrhea.
Gut. 1992; 33: 753–8.
41. Hamza H., Ben K.H., Baumer P., Berard H., et al. Racecadotril
versus placebo in the treatment of acute diarrhea in adults. Aliment Pharmacol
Ther. 1999; 13 (suppl. 6): 15–9.
42. Vetel J.M., Hamza H., Coffin B., Lehert P. Racecadotril efficacy
in the symptomatic treatment of adult acute diarrhoea: a systematic review
and meta-analysis. Int J Clin Med. 2014; 5: 361–75.
43. Coffin B., Hamza H., Vetel J.M., Lehert P. Racecadotril in the treatment
of acute diarrhoea in adults. An individual patient data based metaanalysis.
Int J Clin Med. 2014; 5: 345–60.
44. Roge J., Baumer P., Berard H., Schwartz J.C., et al. The enkephalinase
inhibitor, acetorphan, in acute diarrhoea. A double-blind, controlled
clinical trial versus loperamide. Scand J Gastroenterol. 1993; 28: 352–4.
45. Vetel J.M., Berard H., Fretault N., Lecomte J.M. Comparison
of racecadotril and loperamide in adults with acute diarrhea. Aliment Pharmacol
Ther. 1999; 13 (suppl. 6): 21–6.
46. Prado D. A multinational comparison of racecadotril and loperamide
in the treatment of acute watery diarrhoea in adults. Scand J Gastroenterol.
2002; 37 (6): 656–61.
47. Gallelli L., Colosimo M., Tolotta G.A., et al. Prospective randomized
double-blind trial of racecadotril compared with loperamide in elderly
people with gastroenteritis living in nursing homes. Eur J Clin Pharmacol.
2010; 66: 137–44.
48. Moraes E., Chinzon D., Coleho L.G., Fernandes T.F., et al. A multicentric,
randomised, investigator-blinded, parallel group study to assess
the efficacy, safety and tolerability of racecadotril versus Saccharomyces
boulardii in the treatment of acute diarrhea in adults. Rev Bras Med. 2001;
58 (1–2): 65–74.