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Time-series analysis of ondansetron use in pediatric gastroenteritis

Stephen B Freedman1, Connie Tung, Dennis Cho

  • 1The Hospital for Sick Children, The University of Toronto, Toronto, Canada. stephen.freedman@sickkids.ca

Journal of Pediatric Gastroenterology and Nutrition
|December 15, 2011
PubMed

Insights

Ondansetron use in children with gastroenteritis significantly increased, leading to fewer intravenous rehydration treatments and shorter emergency department stays. This suggests ondansetron improves clinical outcomes for pediatric gastroenteritis patients.

Area of Science:

  • Pediatric Emergency Medicine
  • Clinical Pharmacology

Background:

  • Ondansetron use in emergency departments for pediatric gastroenteritis is rising.
  • The impact of ondansetron on clinical outcomes in this population remains unclear.

Purpose of the Study:

  • To investigate the association between increased ondansetron administration and clinical outcomes in children with gastroenteritis.
  • To evaluate changes in intravenous rehydration rates, emergency department revisits, hospitalizations, and length of stay following ondansetron introduction.

Main Methods:

  • Retrospective cohort study at a Canadian pediatric hospital (2003-2008).
  • Analysis of 3508 patient visits for gastroenteritis in children under 18.
  • Interrupted time-series analysis with segmented logistic regression to assess intravenous rehydration rates.

Main Results:

  • Ondansetron administration increased from 1% to 18% (P < 0.001) during the study period.
  • Intravenous rehydration use decreased significantly from 27% to 13% (P < 0.001).
  • Mean length of stay reduced from 8.6 to 5.9 hours (P = 0.03), with fewer return visits (18% to 13%, P = 0.008).

Conclusions:

  • Increased ondansetron use in pediatric gastroenteritis is associated with reduced intravenous rehydration.
  • Ondansetron administration correlates with decreased emergency department revisits and shorter lengths of stay.
  • Selective use of ondansetron appears to improve clinical outcomes in children with gastroenteritis.
Abstract

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