Objectives: To compare the safety and efficacy of reduced osmolarity oral rehydration solution (ORS) with standard ORS for treating diarrhoea due to cholera. Selection criteria: Randomized controlled trials comparing reduced osmolarity ORS with standard ORS for treating adults and children with acute diarrhoea due to cholera. Data collection and analysis: Two reviewers independently applied eligibility criteria, assessed trial quality, and extracted data. We pooled binary data using relative risks (RR), continuous data using weighted mean difference (WMD) or the standardized mean difference (SMD), and presented the results with 95% confidence intervals (CI). Main results: For glucose-based reduced osmolarity ORS, seven trials (718 participants) met the inclusion criteria. Biochemical hyponatremia (serum sodium Conclusions: In people with cholera, reduced osmolarity ORS is associated with biochemical hyponatremia when compared with standard ORS, although there are similar benefits in terms of other outcomes. Although this risk does not appear to be accompanied by serious consequences, the total patient experience in existing trials is small. Under wider practice conditions, especially where patient monitoring is difficult, caution is warranted.
The Cochrane Database of Systematic Reviews 2004, Issue 4. Art. No.: CD003754. DOI: 10.1002/14651858.CD003754.pub2.