Can ondansetron play a role in the primary treatment of gastroenteritis in children

This article is from NEJM Journal Watch Does Ondansetron Have a Role in Primary Care Management of Pediatric Gastroenteritis? Can ondansetron play a role in the primary treatment of gastroenteritis in children? Comment by Marie Claire O'Dwyer, MB BCh BAO, MPH Children suffering from gastroenteritis took a single dose of ondansetron and reduced their vomiting
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Acute gastroenteritis is usually self-limiting, and oral rehydration is the main treatment
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However, persistent vomiting in the child indicates failure of oral rehydration
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Emergency department studies have demonstrated the effects of oral ondansetron in restricting vomiting and improving oral rehydration (NEJM JW Gen Med May 15 2006 and N Engl J Med 2006; 354:1698), but its role in primary treatment has not been Clear
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The trial included 194 children (age range, age range, 6 months to 6 years old), the investigator randomly assigned them to receive standard treatment (only the prescription of oral rehydration solution) or standard treatment combined with a single oral dose of ondansetron (0.
1 mg/kg)
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The parents of the child will record the child’s symptoms/fluid intake in detail every day for the next 4 hours and the following 7 days
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Significantly fewer children in the ondansetron group had vomiting in the next 4 hours (19.
5% vs.
42.
9%), and parents in the ondansetron group were also more satisfied
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Although there was less vomiting in the ondansetron group, the oral fluid intake of the two groups within 4 hours after randomization was similar (median, 10 mL), and there was no difference in the referral rate and hospitalization rate between the two groups
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Ondansetron was not associated with adverse effects
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Comment: Family physicians and pediatricians often encounter young children who suffer from gastroenteritis and are at risk of dehydration due to persistent vomiting
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A single dose of ondansetron in primary care clinics appears to be safe and reasonable, and this observation may have important implications
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The amount of oral rehydration in both groups in the study was very small, which highlights the importance of emphasizing oral rehydration recommendations
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Commented article Bonvanie IJ et al.
Oral ondansetron for paediatric gastroenteritis in primary care: A randomised controlled trial.
Br J Gen Pract 2021 Oct; 71:e728.
(https://doi.
org/10.
3399/BJGP.
2021.
0211) Related reading NEJM Journal Watch is published by NEJM Group.
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