Abstract
IntroductionDiarrheal diseases are the second leading cause of childhood morbidity and mortality in developing countries and an important cause of malnutrition. An estimated 0.75 million children below 5 years of age die from diarrhea. Vomiting associated with acute gastroenteritis (AGE) is a distressing symptom and limits the success of oral rehydration in AGE leading to an increased use of intravenous rehydration, prolonged emergency department stay and hospitalization. In this review we estimate the effect of antiemetics in gastroenteritis in children.MethodsWe conducted a systematic review of all the efficacy and effectiveness studies. We used a standardized abstraction and grading format and performed meta-analyses for all outcomes with more than two studies. The estimated effect of antiemetics was determined by applying the standard Child Health Epidemiology Reference Group (CHERG) rules.ResultsWe included seven studies in the review. Antiemetics significantly reduced the incidence of vomiting and hospitalization by 54%. Antiemetics also significantly reduced the intravenous fluid requirements by 60%, while it had a non-significant effect on the ORT tolerance and revisit rates.ConclusionAntiemetics are effective for the management of gastroenteritis in children and have the potential to decrease morbidity and mortality burden due to diarrhea, when introduced and scaled up.
Highlights
Diarrheal diseases are the second leading cause of childhood morbidity and mortality in developing countries and an important cause of malnutrition
Antiemetics are effective for the management of gastroenteritis in children and have the potential to decrease morbidity and mortality burden due to diarrhea, when introduced and scaled up
Various drugs were used as antiemetics; four trials used oral ondansetron, one used rectal dimenhydrinate, participants of one trial were either given IV ondansetron or IV metoclopramide, and compared against placebo, while participants of one trial were either given IV ondansetron or IV dexamethasone
Summary
Diarrheal diseases are the second leading cause of childhood morbidity and mortality in developing countries and an important cause of malnutrition. Vomiting associated with acute gastroenteritis (AGE) is a distressing symptom and limits the success of oral rehydration in AGE leading to an increased use of intravenous rehydration, prolonged emergency department stay and hospitalization. An estimated 0.751 million children below 5 years of age die from diarrhea and 8 out of 10 of these deaths occur in the first two years of life [2]. Despite being a subject of controversy, a number of antiemetic agents are commonly administered worldwide in an attempt to reduce vomiting in children with AGE. These include dopamine (D2) antagonists, serotonin or
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