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Ondansetron dosing in pediatric gastroenteritis: a prospective cohort, dose-response study

Stephen B Freedman1, Elizabeth C Powell, Alejandro A Nava-Ocampo

  • 1Division of Pediatric Emergency Medicine, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.

Paediatric Drugs
|October 30, 2010
PubMed

Insights

Higher doses of oral ondansetron (0.13-0.26 mg/kg) did not improve efficacy or increase side effects in children with gastroenteritis. The study found similar outcomes for vomiting, rehydration, and hospitalization across the tested ondansetron dosage range.

Area of Science:

  • Pediatric Gastroenterology
  • Clinical Pharmacology
  • Emergency Medicine

Background:

  • Ondansetron is frequently used for pediatric acute gastroenteritis-related emesis.
  • The optimal ondansetron dosage for this population remains undetermined.

Purpose of the Study:

  • To assess the efficacy and safety of higher oral ondansetron doses in children with gastroenteritis.
  • To identify any dose-dependent side effects of ondansetron in this pediatric cohort.

Main Methods:

  • Prospective analysis of 105 children (0.5-8.2 years) receiving oral ondansetron (0.13-0.26 mg/kg) for gastroenteritis-induced dehydration.
  • Efficacy outcomes included vomiting episodes, oral fluid intake, weight gain, and need for IV rehydration or hospitalization.
  • Diarrhea episodes were monitored for potential dose-related adverse effects.

Main Results:

  • No significant association was found between ondansetron dose and vomiting episodes, fluid consumption, or weight gain.
  • Higher ondansetron doses did not correlate with a reduced incidence of ongoing vomiting, hospitalization, or need for intravenous rehydration.
  • The number of diarrhea episodes per hour also showed no dose-dependent relationship with ondansetron administration.

Conclusions:

  • Within the 0.13-0.26 mg/kg range, higher oral ondansetron doses offer no superior efficacy for emesis control in pediatric gastroenteritis.
  • Increased ondansetron dosage in this range was not linked to a higher occurrence of side effects, including diarrhea.
  • Ondansetron effectively reduces emesis in children with acute gastroenteritis, with similar outcomes observed across the studied dose range.
Abstract

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