Ondansetron reduces IV fluid administration in paediatric gastroenteritis

Use of oral ondansetron in the treatment of children with gastroenteritis who seek emergency department (ED) care works to reduce index ED visit intravenous (IV) fluid administration, a study has found. The drug has null effects on other outcomes.

Researchers conducted a secondary analysis of two trials involving children aged 3–48 months with gastroenteritis and at least three episodes of vomiting in the 24 hours preceding ED presentation. Oral ondansetron was administered at the discretion of the care provider.

Of the 794 children (median age 16.0 months) included, 398 (50.1 percent) received oral ondansetron. In propensity-adjusted analysis (n=528), children treated with oral ondansetron were less likely to receive IV fluids at the index ED visit (adjusted odds ratio [aOR], 0.50, 95 percent confidence interval [CI], 0.29–0.88) compared with those who did not receive the drug.

Meanwhile, there were no between-group differences in the frequencies of IV fluid administration within the first 72 hours (aOR, 0.65, 95 percent CI, 0.39–1.10) or hospitalization at the index visit (aOR, 0.31, 95 percent CI, 0.09–1.10) or the subsequent 72 hours (aOR, 0.52, 95 percent CI, 0.21–1.28).

Likewise, oral ondansetron did not confer significant benefits for episodes of vomiting (adjusted relative risk [aRR], 0.86, 95 percent CI, 0.63–1.19) and diarrhoea (aRR, 1.11, 95 percent CI, 0.93–1.32) during the 24 hours following ED discharge.