Adjunctive sucralfate falls short of improving oral intake in kids with infectious mouth ulcers

Use of sucralfate as an adjunct to analgesics does not appear to help improve oral intake of children with acute oral infectious ulcers, as shown in a study.

The study included 100 children (median age 1.38 years) with mild dehydration (clinical dehydration score of 1) due to acute, infectious mouth ulcers and poor oral intake. They were randomized to receive sucralfate at 20 mg/kg per dose (up to 1 g; n=49) or a placebo solution (n=51) as an adjunct to acetaminophen at 15 mg/kg or ibuprofen at 10 mg/kg.

The primary outcome was oral fluid intake within 60 minutes of medication administration. Repeat emergency department (ED) visits, length of stay in ED, admission rate, intravenous hydration rate, adverse event rate, and emergency physician’s determination of the adequacy of oral intake were also assessed as secondary outcomes.

Results showed no significant between-group difference in oral fluid intake 1 hour after administration of adjunctive medication. The median intakes were 9.7 mL/kg in the sucralfate group and 10.7 mL/kg in the placebo group (difference, –1 mL/kg, 95 percent confidence interval [CI], −2.0 to 4.8).

Emergency physician’s report indicated that the secondary outcomes were significant only for adequate oral intake: 71 percent in the sucralfate group as opposed to 88 percent in the placebo group (difference, −16.8 percent, 95 percent CI, −32.2 to −1.4).