Vomiting limits the success of oral rehydration in children with gastroenteritis.
Dr Stephen Freedman and colleagues from Canada determined whether a single oral dose of ondansetron, an antiemetic, would improve gastroenteritis outcomes in children.
The team enrolled 215 children 6 months through 10 years of age who were treated in a pediatric emergency department for gastroenteritis and dehydration.
The children were randomly assigned to treatment with orally disintegrating ondansetron tablets or placebo.
|14% with ondansetron vomited vs 35% receiving placebo|
|New England Journal of Medicine|
After randomization, the children received oral-rehydration therapy according to a standardized protocol.
The research team's primary outcome was the proportion who vomited while receiving oral rehydration.
The secondary outcomes were the number of episodes of vomiting, and the proportions who were treated with intravenous rehydration or hospitalized.
The researchers found that 14% of children who received ondansetron vomited compared with 35% receiving placebo.
The treated children not only vomited less often, but also had greater oral intake.
The team noted that 14% of children receiving ondansetron had to be treated by intravenous rehydration compared with 31% receiving placebo.
Those receiving treatment had a 12% reduced mean length of stay in the emergency department.
The researchers observed that hospitalization rates were also reduced in the ondensetron group, although this was not significant.
Return visits to the emergency department also did not differ significantly between the 2 groups.
Dr Freedman's team concluded, “In children with gastroenteritis and dehydration, a single dose of oral ondansetron reduces vomiting.”
“It facilitates oral rehydration and may thus be well suited for use in the emergency department.”