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Updated: May 1, 2026

Author Spotlight: Alleviating Nausea and Vomiting in Pregnancy with Safe and Effective Auricular Acupuncture
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Italian multidisciplinary delphi consensus on home management of nausea and vomiting in children with acute

Ruggiero Francavilla1, Fernanda Cristofori1, Gian Luigi Marseglia2,3

  • 1Interdisciplinary Department of Medicine, Pediatric Section, Children's Hospital 'Giovanni XXIII', University of Bari Aldo Moro, Bari, Italy.

Frontiers in Pediatrics
|April 30, 2026
PubMed

Insights

Vomiting in pediatric acute gastroenteritis (AGE) is common. Expert consensus supports cautious antiemetic use, like metoclopramide, for home management in select cases to aid rehydration and reduce distress.

Area of Science:

  • Pediatric Gastroenterology
  • Clinical Pharmacology
  • Evidence-Based Medicine

Background:

  • Vomiting in pediatric acute gastroenteritis (AGE) causes significant distress and hinders oral rehydration.
  • Limited guidance exists for home management and antiemetic use in children, compounded by regulatory issues.

Purpose of the Study:

  • To establish expert consensus on managing vomiting in pediatric AGE.
  • To provide recommendations for the safe and effective use of antiemetics, particularly metoclopramide, in home settings.

Main Methods:

  • A modified Delphi consensus process was employed.
  • A national multidisciplinary panel of 70 Italian pediatricians participated in three phases: literature review, anonymous online rating, and refinement.
  • Twenty-one statements on clinical aspects and antiemetic use were rated using a five-point Likert scale, with consensus defined as ≥80% agreement.

Main Results:

  • All 21 statements achieved consensus (83%-100% agreement).
  • High agreement was reached on the clinical impact of vomiting in AGE, its mechanisms, and metoclopramide safety (dosing, age considerations, counseling).
  • The panel agreed that cautious antiemetic use, especially metoclopramide, can support home management for persistent vomiting if safety protocols are followed.

Conclusions:

  • This Delphi consensus offers practical, expert-backed recommendations for managing nausea and vomiting in pediatric AGE at home.
  • Oral rehydration solutions (ORS) are primary treatment; metoclopramide may be considered for symptom resolution and facilitating rehydration in select cases.
  • Strict risk-benefit assessment and adherence to clinical safeguards are crucial when prescribing antiemetics like metoclopramide.
Abstract

Keywords:
acute gastroenteritisantiemeticschilddelphi consensusmetoclopramidenauseavomiting

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