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The addition of ondansetron to a oral rehydration protocol for children with acute gastroenteritis

C Mullarkey1, E Crowley2, C Martin2

  • 1Emergency Department, National Children's Hospital, Tallaght, Dublin. caitriona.mullarkey@hse.ie

Irish Medical Journal
|January 15, 2014
PubMed

Insights

Adding Ondansetron to oral rehydration therapy (ORT) significantly reduced intravenous fluid (IVF) use in pediatric emergency department patients with gastroenteritis. This intervention also decreased hospital admissions, improving patient outcomes.

Area of Science:

  • Pediatric Emergency Medicine
  • Gastroenterology
  • Pharmacology

Background:

  • Acute gastroenteritis is a common cause of dehydration in children presenting to emergency departments.
  • Oral rehydration therapy (ORT) is the standard initial treatment, but some children fail to respond.
  • Intravenous fluid (IVF) administration and hospital admission are common outcomes for refractory cases.

Purpose of the Study:

  • To evaluate the impact of adding Ondansetron to an established ORT protocol.
  • To assess changes in IVF administration and hospital admission rates.
  • To determine the effectiveness of Ondansetron in facilitating successful oral rehydration.

Main Methods:

  • A retrospective study comparing two six-week periods (2008 vs. 2009).
  • Children received standard ORT in 2008; Ondansetron was added to ORT for refractory cases in 2009.
  • Outcome measures included IVF administration rates, admission rates, and successful oral rehydration.

Main Results:

  • IVF administration decreased by 19% (40.9% in 2008 vs. 21.7% in 2009, p < 0.0001).
  • Admission rates showed a non-significant reduction of 1.6% (14.41% vs. 12.82%, p=0.62).
  • Of 34 patients receiving Ondansetron, 79% were successfully rehydrated orally.

Conclusions:

  • Ondansetron is an effective adjunct to ORT in pediatric gastroenteritis.
  • The addition of Ondansetron significantly reduces the need for intravenous fluids.
  • This strategy improves oral rehydration success rates and potentially decreases admissions.

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