Abstract
Objective
To evaluate the efficacy of ondansetron for the treatment of vomiting and thus reducing the need for intravenous (IV) rehydration in children with gastroenteritis.
Design
Double-blind, placebo-controlled, randomized trial.
Setting
Pediatric ward of An Giang General Hospital, South Vietnam, between December 2013 and June 2014.
Participants
61 inpatient children (age 11–60 mo) suffering from gastroenteritis with vomiting. Exclusion criteria were: underlying chronic conditions, immunodeficiency, malnutrition or history of allergy to ondansetron.
Intervention
Single bolus of IV ondansetron at a dose of 0.2 mg/kg or placebo.
Outcome measures
Proportion of patients who needed IV rehydration, proportion of patients with cessation of vomiting, amount of oral rehydration solution intake, duration of diarrhea and the length of hospital stay.
Results
After drug administration, 22 (73%) of the 30 patients in the ondansetron group had complete cessation of vomiting compared with 7 (23%) of the 31 patients in the placebo group (RR 0.32; 95% CI 0.16 to 0.63, P<0.001). 3 (10%) patients in the ondansetron group required IV rehydration as compared with 12 (39%) in the placebo group (RR 0.51; 95% CI 0.33 to 0.79, P=0.009). The median amount of oral rehydration solution intake in 24 hours was significantly greater in the ondansetron group (450 mL vs 350 mL, P=0.019). The duration of diarrhea and the length of hospital stay were not different between the two groups.
Conclusion
In hospitalized children having gastro-enteritis associated with emesis, ondansetron is effective in the cessation of episodes of vomiting and in lowering the rates of IV rehydration, without reducing the duration of diarrhea and hospital stay.
Similar content being viewed by others
References
Khanna R, Lakhanpaul M, Burman-Roy S. Diarrhoea and vomiting caused by gastroenteritis in children under 5 years: Summary of NICE guidance. BMJ. 2009;25:1009–12.
Reis EC, Goepp JG, Katz S, Santosham M. Barriers to use of oral rehydration therapy. Pediatrics. 1994;93:708–11.
Conners GP, Barker WH, Mushlin AI, Goepp JG. Oral versus intravenous: rehydration preferences of pediatric emergency medicine fellowship directors. Pediatr Emerg Care. 2000;16:335–8.
Freedman SB, Steiner MJ, Chan KJ. Oral ondansetron administration in emergency departments to children with gastroenteritis: an economic analysis. PLoS Med. 2010;7:e1000350.
Domino KB, Anderson EA, Polissar NL, Posner KL. Comparative efficacy and safety of ondansetron, droperidol and metoclopramide for preventing postoperative nausea and vomiting: A meta-analysis. Anesth Analg. 1999;88: 1370–9.
Jürgens H, McQuade B. Ondansetron as prophylaxis for chemotherapy and radiotherapy-induced emesis in children. Oncology. 1992;49:279–85.
Lippens RJ, Broeders GC. Ondansetron in radiation therapy of brain tumor in children. Pediatr Hematol Oncol. 1996;13:247–52.
Fedorowicz Z, Jagannath VA, Carter B. Antiemetics for reducing vomiting related to acute gastroenteritis in children and adolescents. Cochrane Database Syst Rev. 2011;9:CD005506.
Tomasik E, Ziólkowska E, Kolodziej M, Szajewska H. Systematic review with meta-analysis: Ondansetron for vomiting in children with acute gastroenteritis. Aliment Pharmacol Ther. 2016;44:438-46.
Freedman SB, Powell EC, Nava-Ocampo AA, Finkelstein Y. Ondansetron dosing in pediatric gastroenteritis: A prospective cohort, dose-response study. Paediatr Drugs. 2010;12:405–10.
Roslund G, Hepps TS, McQuillen KK. The role of oral ondansetron in children with vomiting as a result of acute gastritis/gastroenteritis who have failed oral rehydration therapy: a randomized controlled trial. Ann Emerg Med. 2008;52:22–9.
Cubeddu LX, Trujillo LM, Talmaciu I, Gonzalez V, Guariguata J, Seijas J, et al. Antiemetic activity of ondansetron in acute gastroenteritis. Aliment Pharmacol Ther. 1997;11:185–91.
Freedman SB, Adler M, Seshadri R, Powell EC. Oral ondansetron for gastroenteritis in a pediatric emergency department. N Engl J Med. 2006;354:1698–705.
Danewa AS, Shah D, Batra P, Bhattacharya SK, Gupta P. Oral ondansetron in management of dehydrating diarrhea with vomiting in children aged 3 months to 5 years: A randomized controlled trial. J Pediatr. 2016;169:105–9.
Funding
Funding: None. Medicaments were provided by Department of Pharmacy, An Giang Hospital.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Rang, N.N., Chanh, T.Q., My, P.T. et al. Single-dose Intravenous Ondansetron in Children with Gastroenteritis: A Randomized Controlled Trial. Indian Pediatr 56, 468–471 (2019). https://doi.org/10.1007/s13312-019-1570-y
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13312-019-1570-y