ORIGINAL ARTICLES Oral rehydration of infants in a large urban U.S. medical center ,4 prospective randomized study of 100 well-nourished infiTnts with acute gastroenteritis resulting in dehydration and acidosis was carried out at the Jackson Memorial Hospital, Miami from 1981 to 1983. Patients were randomly assigned to receive either standard intravenous therapy or oral rehydration. Infants in the latter group first received solution A containing 75 mEq/L sodium, 30 mEq/L potassium, 75 mEq/L chlorine, 30 mEq/L bicarbonate, and 2 mg/dl glucose. After ad libitum feeding for six hours, solution B containing 50 mEq/L sodium, 30 mEq/L potassium, 50 mEq/L chlorine, 30 mEq/L bicarbonate, and 3 mg/dl glucose was given. With three exceptions (6%), oral rehydration was comparable to the intravenous regimen in clinical estimates of improvement, although the oral group had more stools in the first day. The oral group had faster correction of acidosis and a sustained rise in serum potassium concentration, whereas in the intravenous 'group the potassium concentration showed first a drop with a later increase, but levels were at all times below those in the oral group. Although potassium was given from the beginning of oral rehydration, and at a higher concentration than recommended by the World Health Organization, no hyperkalemia occurred. We concluded that oral therapy is safe, less expensive for patients, and more convenient for the medical and nursing stafJZ (J PEDIATR 107:14, 1985) Akram M. Tamer, M.D., Lawrence B. Friedman, M.D., Stefan R. W. Maxwell, M.D., Harry A. Cynamon, M.D., Hugo N. Perez, M.D., and William W. Cleveland, M.D. Miami, Florida THE BASIC PROBLEM in the management of dehydration caused by diarrhea is replacement of water and electrolyte deficits. Traditional therapy has depended on the intrave- nous replacement of these losses. When Schultz and Zalusky ~ showed in the rabbit, and Binder 2 in the human jejunum, that glucose enhanced sodium absorption, an important advance in the principles of oral rehydration was established. Oral therapy has been successfully used in underdeveloped countries in dehydrated infants and chil- dren with viral and bacterial diarrhea, 3-5 but physicians in the United States have been reluctant to change from the established intravenous method of treating dehydration. From the Department of Pediatrics, University of Miami School of Medicine. Submitted for publication Sept. 10, 1984; accepted Dec. 14, 1984. Reprint requests: Akram M. Tamer, M.D., Department of Pedi- atrics (R l 3 l ), University of Miami, P.O. Box 016960, Miami, FL 33101. Diarrhea with dehydration is a frequent cause for admission to the Jackson Memorial Hospital, Miami. Until 1981, initial therapy involved the administration of fluids intravenously according to accepted regimens. From 1981 to 1983, 100 infants were prospectively studied after random assignment to receive orally or intravenously administered therapy to evaluate the substitution of oral for intravenous rehydration. We undertook oral rehydra- tion in patients admitted to the hospital in an effort re, reduce the time required by nurses and physicians to start, monitor, and maintain intravenous infusions, as well as to avoid the expense of equipment and solutions required for intravenous rehydration. Theplan depended on the moth- er's availability and willingness to remain with the child. METHODS One hundred previously healthy infants aged 3 to 33 months were admitted to the hospital from July 1981 through October I983 because of acute enteritis and dehydration with --<10% estimated weight loss (Table I). 14 The Journal of P E D1A T R I C S