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Systematic review with meta‐analysis: ondansetron for vomiting in children with acute gastroenteritis
Author(s) -
Tomasik E.,
Ziółkowska E.,
Kołodziej M.,
Szajewska H.
Publication year - 2016
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.13728
Subject(s) - ondansetron , medicine , vomiting , acute gastroenteritis , meta analysis , medline , pediatrics , intensive care medicine , political science , law
Summary Background Vomiting in children with acute gastroenteritis is a common symptom, and it is considered to be the main cause of failure of oral rehydration therapy. Aim To systematically update evidence on the effects of ondansetron (5‐ HT 3 serotonin antagonist) for vomiting in children with acute gastroenteritis. Methods The Cochrane Library, MEDLINE and EMBASE databases were searched up to April 2016, with no language restrictions, for randomised controlled trials ( RCT s). Reference lists of reviews and included studies were examined. Results Ten RCT s involving 1215 participants were included. Treatment with ondansetron compared with placebo increased the chance for vomiting cessation up to 1 h after drug administration, relative risk, RR , 1.49 (95% confidence interval 1.17–1.89), but there was no difference between the groups after 4, 24 and 48 h. Treatment with ondansetron compared with placebo reduced the risk of failure of oral rehydration therapy, RR 0.5 (0.37–0.69), increased the intake of oral rehydration solution in 1 h and 4 h, mean difference: 43 mL/1 h (15.5–70.5), and 91 mL/4 h (35–147), respectively, reduced the risk of hospitalisation, RR 0.53 (0.29–0.97), and reduced the need for intravenous rehydration, RR 0.45 (0.31–0.63); however, it had no effect on the need for return visits to the emergency department, RR 1.14 (0.72–1.8). Adverse effects were similar in both groups. Conclusions Compared with placebo, ondansetron administration for vomiting in children with acute gastroenteritis can improve the efficacy of oral rehydration therapy.