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Oral ondansetron for paediatric gastroenteritis in primary care: a randomised controlled trial

Irma J Bonvanie1, Anouk Ah Weghorst1, Gea A Holtman1

  • 1Department of General Practice and Elderly Care Medicine, University of Groningen, The Netherlands.

The British Journal of General Practice : the Journal of the Royal College of General Practitioners
|August 24, 2021
PubMed

Insights

Ondansetron significantly reduced vomiting in children with acute gastroenteritis (AGE) in primary care. This treatment improved parental satisfaction and reduced dehydration risk, enhancing general practice care.

Area of Science:

  • Pediatric Medicine
  • Gastroenterology
  • Clinical Pharmacology

Background:

  • Acute gastroenteritis (AGE) is a common childhood illness, particularly in those under 5 years.
  • Vomiting associated with AGE can lead to dehydration and distress.
  • Ondansetron has shown efficacy in reducing vomiting in secondary care settings.

Purpose of the Study:

  • To evaluate the effectiveness of adding oral ondansetron to usual care for treating vomiting in children with AGE.
  • To assess ondansetron's impact on vomiting frequency and parental satisfaction in an out-of-hours primary care setting.

Main Methods:

  • A pragmatic randomized controlled trial was conducted in three out-of-hours primary care centers.
  • 194 children aged 6 months to 6 years with diagnosed AGE and significant vomiting were randomized.
  • The intervention group received oral ondansetron (0.1 mg/kg) plus oral rehydration therapy, while the control group received only oral rehydration therapy.

Main Results:

  • A single dose of oral ondansetron reduced the proportion of children with persistent vomiting within 4 hours from 42.9% to 19.5%.
  • Ondansetron significantly decreased the number of vomiting episodes and improved overall parental satisfaction with treatment (P=0.027).
  • The number needed to treat with ondansetron was four to prevent ongoing vomiting.

Conclusions:

  • Oral ondansetron is effective in primary care for reducing vomiting in children with AGE, mitigating dehydration risk.
  • This intervention improves treatment efficacy and parental satisfaction, offering a valuable addition to general practice.
  • Ondansetron use in primary care can enhance the quality and effectiveness of managing pediatric gastroenteritis.
Abstract

Keywords:
acute gastroenteritischildoral ondansetronout of hoursprimary carevomiting

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