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Oral ondansetron for gastroenteritis in a pediatric emergency department.
N Engl J Med. 2006 Apr 20; 354(16):1698-705.NEJM

Abstract

BACKGROUND

Vomiting limits the success of oral rehydration in children with gastroenteritis. We conducted a double-blind trial to determine whether a single oral dose of ondansetron, an antiemetic, would improve outcomes in children with gastroenteritis.

METHODS

We enrolled 215 children 6 months through 10 years of age who were treated in a pediatric emergency department for gastroenteritis and dehydration. After being randomly assigned to treatment with orally disintegrating ondansetron tablets or placebo, the children received oral-rehydration therapy according to a standardized protocol. The 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.

RESULTS

As compared with children who received placebo, children who received ondansetron were less likely to vomit (14 percent vs. 35 percent; relative risk, 0.40; 95 percent confidence interval, 0.26 to 0.61), vomited less often (mean number of episodes per child, 0.18 vs. 0.65; P<0.001), had greater oral intake (239 ml vs. 196 ml, P=0.001), and were less likely to be treated by intravenous rehydration (14 percent vs. 31 percent; relative risk, 0.46; 95 percent confidence interval, 0.26 to 0.79). Although the mean length of stay in the emergency department was reduced by 12 percent in the ondansetron group, as compared with the placebo group (P=0.02), the rates of hospitalization (4 percent and 5 percent, respectively; P=1.00) and of return visits to the emergency department (19 percent and 22 percent, P=0.73) did not differ significantly between groups.

CONCLUSIONS

In children with gastroenteritis and dehydration, a single dose of oral ondansetron reduces vomiting and facilitates oral rehydration and may thus be well suited for use in the emergency department.

Authors+Show Affiliations

Division of Pediatric Emergency Medicine, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada. stephen.freedman@sickkids.caNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16625009

Citation

Freedman, Stephen B., et al. "Oral Ondansetron for Gastroenteritis in a Pediatric Emergency Department." The New England Journal of Medicine, vol. 354, no. 16, 2006, pp. 1698-705.
Freedman SB, Adler M, Seshadri R, et al. Oral ondansetron for gastroenteritis in a pediatric emergency department. N Engl J Med. 2006;354(16):1698-705.
Freedman, S. B., Adler, M., Seshadri, R., & Powell, E. C. (2006). Oral ondansetron for gastroenteritis in a pediatric emergency department. The New England Journal of Medicine, 354(16), 1698-705.
Freedman SB, et al. Oral Ondansetron for Gastroenteritis in a Pediatric Emergency Department. N Engl J Med. 2006 Apr 20;354(16):1698-705. PubMed PMID: 16625009.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Oral ondansetron for gastroenteritis in a pediatric emergency department. AU - Freedman,Stephen B, AU - Adler,Mark, AU - Seshadri,Roopa, AU - Powell,Elizabeth C, PY - 2006/4/21/pubmed PY - 2006/4/28/medline PY - 2006/4/21/entrez SP - 1698 EP - 705 JF - The New England journal of medicine JO - N Engl J Med VL - 354 IS - 16 N2 - BACKGROUND: Vomiting limits the success of oral rehydration in children with gastroenteritis. We conducted a double-blind trial to determine whether a single oral dose of ondansetron, an antiemetic, would improve outcomes in children with gastroenteritis. METHODS: We enrolled 215 children 6 months through 10 years of age who were treated in a pediatric emergency department for gastroenteritis and dehydration. After being randomly assigned to treatment with orally disintegrating ondansetron tablets or placebo, the children received oral-rehydration therapy according to a standardized protocol. The 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. RESULTS: As compared with children who received placebo, children who received ondansetron were less likely to vomit (14 percent vs. 35 percent; relative risk, 0.40; 95 percent confidence interval, 0.26 to 0.61), vomited less often (mean number of episodes per child, 0.18 vs. 0.65; P<0.001), had greater oral intake (239 ml vs. 196 ml, P=0.001), and were less likely to be treated by intravenous rehydration (14 percent vs. 31 percent; relative risk, 0.46; 95 percent confidence interval, 0.26 to 0.79). Although the mean length of stay in the emergency department was reduced by 12 percent in the ondansetron group, as compared with the placebo group (P=0.02), the rates of hospitalization (4 percent and 5 percent, respectively; P=1.00) and of return visits to the emergency department (19 percent and 22 percent, P=0.73) did not differ significantly between groups. CONCLUSIONS: In children with gastroenteritis and dehydration, a single dose of oral ondansetron reduces vomiting and facilitates oral rehydration and may thus be well suited for use in the emergency department. SN - 1533-4406 UR - https://www.unboundmedicine.com/medline/citation/16625009/Oral_ondansetron_for_gastroenteritis_in_a_pediatric_emergency_department_ L2 - https://www.nejm.org/doi/10.1056/NEJMoa055119?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -