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Dimenhydrinate in children with infectious gastroenteritis: a prospective, RCT.
Pediatrics. 2009 Oct; 124(4):e622-32.Ped

Abstract

OBJECTIVE

Vomiting is a common symptom in children with infectious gastroenteritis. It contributes to fluid loss and is a limiting factor for oral rehydration therapy. Dimenhydrinate has traditionally been used for children with gastroenteritis in countries such as Canada and Germany. We investigated the efficacy and safety of dimenhydrinate in children with acute gastroenteritis.

METHODS

We performed a prospective, randomized, placebo-controlled, multicenter trial. We randomly assigned 243 children with presumed gastroenteritis and vomiting to rectal dimenhydrinate or placebo. Children with no or mild dehydration were included. All children received oral rehydration therapy. Primary outcome was defined as weight gain within 18 to 24 hours after randomization. Secondary outcomes were number of vomiting episodes, fluid intake, parents' assessment of well-being, number of diarrheal episodes, and admission rate to hospital. We recorded potential adverse effects.

RESULTS

Change of weight did not differ between children who received dimenhydrinate or placebo. The mean number of vomiting episodes between randomization and follow-up visit was 0.64 in the dimenhydrinate group and 1.36 in the placebo group. In total, 69.6% of the children in the dimenhydrinate group versus 47.4% in the placebo group were free of vomiting between randomization and the follow-up visit. Hospital admission rate, fluid intake, general well-being of the children, and potential adverse effects, including the number of diarrhea episodes, were similar in both groups.

CONCLUSIONS

Dimenhydrinate reduces the frequency of vomiting in children with mild dehydration; however, the overall benefit is low, because it does not improve oral rehydration and clinical outcome.

Authors+Show Affiliations

Section of Pediatric Gastroenterology, University Hospital for Children and Adolescents, University of Leipzig, Leipzig, Germany. holm.uhlig@medizin.unileipzig.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial, Phase IV
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19752076

Citation

Uhlig, Ulrike, et al. "Dimenhydrinate in Children With Infectious Gastroenteritis: a Prospective, RCT." Pediatrics, vol. 124, no. 4, 2009, pp. e622-32.
Uhlig U, Pfeil N, Gelbrich G, et al. Dimenhydrinate in children with infectious gastroenteritis: a prospective, RCT. Pediatrics. 2009;124(4):e622-32.
Uhlig, U., Pfeil, N., Gelbrich, G., Spranger, C., Syrbe, S., Huegle, B., Teichmann, B., Kapellen, T., Houben, P., Kiess, W., & Uhlig, H. H. (2009). Dimenhydrinate in children with infectious gastroenteritis: a prospective, RCT. Pediatrics, 124(4), e622-32. https://doi.org/10.1542/peds.2008-1650
Uhlig U, et al. Dimenhydrinate in Children With Infectious Gastroenteritis: a Prospective, RCT. Pediatrics. 2009;124(4):e622-32. PubMed PMID: 19752076.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dimenhydrinate in children with infectious gastroenteritis: a prospective, RCT. AU - Uhlig,Ulrike, AU - Pfeil,Nicole, AU - Gelbrich,Götz, AU - Spranger,Christian, AU - Syrbe,Steffen, AU - Huegle,Boris, AU - Teichmann,Barbara, AU - Kapellen,Thomas, AU - Houben,Peggy, AU - Kiess,Wieland, AU - Uhlig,Hans Holm, Y1 - 2009/09/14/ PY - 2009/9/16/entrez PY - 2009/9/16/pubmed PY - 2009/10/24/medline SP - e622 EP - 32 JF - Pediatrics JO - Pediatrics VL - 124 IS - 4 N2 - OBJECTIVE: Vomiting is a common symptom in children with infectious gastroenteritis. It contributes to fluid loss and is a limiting factor for oral rehydration therapy. Dimenhydrinate has traditionally been used for children with gastroenteritis in countries such as Canada and Germany. We investigated the efficacy and safety of dimenhydrinate in children with acute gastroenteritis. METHODS: We performed a prospective, randomized, placebo-controlled, multicenter trial. We randomly assigned 243 children with presumed gastroenteritis and vomiting to rectal dimenhydrinate or placebo. Children with no or mild dehydration were included. All children received oral rehydration therapy. Primary outcome was defined as weight gain within 18 to 24 hours after randomization. Secondary outcomes were number of vomiting episodes, fluid intake, parents' assessment of well-being, number of diarrheal episodes, and admission rate to hospital. We recorded potential adverse effects. RESULTS: Change of weight did not differ between children who received dimenhydrinate or placebo. The mean number of vomiting episodes between randomization and follow-up visit was 0.64 in the dimenhydrinate group and 1.36 in the placebo group. In total, 69.6% of the children in the dimenhydrinate group versus 47.4% in the placebo group were free of vomiting between randomization and the follow-up visit. Hospital admission rate, fluid intake, general well-being of the children, and potential adverse effects, including the number of diarrhea episodes, were similar in both groups. CONCLUSIONS: Dimenhydrinate reduces the frequency of vomiting in children with mild dehydration; however, the overall benefit is low, because it does not improve oral rehydration and clinical outcome. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/19752076/Dimenhydrinate_in_children_with_infectious_gastroenteritis:_a_prospective_RCT_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=19752076 DB - PRIME DP - Unbound Medicine ER -