Abstract
BackgroundAcute gastroenteritis (AGE) affects almost all children aged ≤5 years. In secondary care, ondansetron was found to be effective at reducing vomiting.AimTo determine the effectiveness of adding oral ondansetron to care as usual (CAU) to treat vomiting in children with AGE attending out-ofhours primary care (OOH-PC).Design and settingA pragmatic randomised controlled trial at three OOH-PC centres in the north of the Netherlands (Groningen, Zwolle, and Assen), with a follow-up of 7 days.MethodChildren were included if they were: aged 6 months–6 years; AGE diagnosed by a GP; ≥4 reported episodes of vomiting in the 24 hours before presentation; ≥1 reported episode of vomiting in the 4 hours before presentation; and written informed consent from both parents. Children were randomly allocated to either the control group or the intervention group. The control group received CAU, namely oral rehydration therapy. The intervention group received CAU plus one dose of oral ondansetron (0.1 mg/kg).ResultsIn total, 194 children were included for randomisation. One dose of oral ondansetron decreased the proportion of children who continued vomiting within 4 hours from 42.9% to 19.5%, with an odds ratio of 0.37 (95% confidence interval [CI] = 0.20 to 0.72, number needed to treat: four). Ondansetron also decreased the number of vomiting episodes within 4 hours (incidence rate ratio 0.51 [95% CI = 0.29 to 0.88]) and improved overall parental satisfaction with treatment (P = 0.027).ConclusionChildren with AGE and increased risk of dehydration due to vomiting could be treated with ondansetron in primary care to stop vomiting more quickly and increase parental satisfaction with treatment. These results could be used to improve the quality and efficacy of general practice medicine.
Highlights
Acute gastroenteritis (AGE) is common in young children and, it is typically self-limiting, severe dehydration is an important complication.[1]
One dose of oral ondansetron decreased the proportion of children who continued vomiting within 4 hours from 42.9% to 19.5%, with an odds ratio of 0.37 (95% confidence interval [CI] = 0.20 to 0.72, number needed to treat: four)
Ondansetron decreased the number of vomiting episodes within 4 hours and improved overall parental satisfaction with treatment (P = 0.027)
Summary
Acute gastroenteritis (AGE) is common in young children and, it is typically self-limiting, severe dehydration is an important complication.[1] Approximately 5% of all GP consultations with children in the Netherlands are for AGE.[2] Among those seen in primary care, 8.1% are referred to specialist care and 8000 are admitted to the hospital each year.[2,3] it is thought that many of these referrals and admissions can be avoided.[4]. Acute gastroenteritis (AGE) affects almost all children aged ≤5 years. Ondansetron was found to be effective at reducing vomiting
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
