Ondansetron for food protein-induced enterocolitis syndrome

Area of Science:

• Pediatric Allergy and Immunology
• Gastroenterology
• Clinical Pharmacology

Background:

• Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE mediated allergic reaction in infants and children.
• Acute FPIES symptoms can include vomiting, diarrhea, and lethargy, often requiring prompt management.
• Ondansetron has shown efficacy in managing acute FPIES symptoms via intravenous administration.

Observation:

• This study reports on the use of intramuscular ondansetron in 5 children undergoing oral food challenge (OFC) for FPIES.
• Intramuscular ondansetron was administered to manage acute symptoms that arose during OFC.
• The administration route was intramuscular, differing from previous intravenous studies.

Findings:

• Intramuscular ondansetron resulted in complete and rapid symptom resolution within 15 minutes in all 5 children.
• This administration route eliminated the need for intravenous access or steroid administration.
• The intramuscular route facilitates easier administration, including potential home use.

Implications:

• Intramuscular ondansetron presents a highly useful and practical option for managing acute FPIES.
• The ease of administration allows for potential outpatient or home-based treatment initiation.
• Further research is warranted to confirm the efficacy and establish guidelines for intramuscular ondansetron in FPIES management.