The Effect of Multi-Dose Ondansetron on the Vomiting Associated with Acute Gastroenteritis in Children Less than 5 Years Old

Abstract Background Acute gastroenteritis is a leading cause of emergency department visits and hospitalization among children. Oral rehydration therapy is recommended for children with mild to moderate dehydration, but children who present with vomiting are frequently offered intravenous rehydration in the emergency department. Ondansetron is the only antiemetic agent with consistent, proven efficacy in reducing vomiting from acute gastroenteritis and promote oral rehydration. Aim of the Work To evaluate the effect of multiple doses of ondansetron on the control of vomiting associated with acute gastroenteritis in the children in comparison to a single dose. Patients and Methods This was a randomized controlled study that was conducted on 70 children less than 5 years old presenting to the emergency department of pediatric hospital, Ain Shams University in a period of 6 months with acute gastroenteritis. They were divided into 2 groups (35 patients in each group): Arm one (odd numbers): received single dose of ondansetron (Zofran-intramascular) the dose 0.15mg/kg to a maximum 8 mg. Arm two (even numbers): received (6 doses) of ondansetron (Zofran- intramascular) the dose 0.15mg/kg to a maximum 8 mg every 8 hours for 48hrs. The modified Vesikari scale score was performed at different times as gastroenteritis severity scale. Results Both groups were comparable regarding age, sex, weight and height. There was no statistically significant difference found between group A and group B regarding all parameters of modified Vesikari scale score (MVS) at time of enrollment, at 24 hours, 48 hours and at 7 days with p-value = 0.400, 0.394, 0.451 and 0.746. There was no statistically significant difference found between both groups regarding side effects of ondansetron while there was statistically significant increase in the percentage of patients with diarrhea in group B (17.1%) than group A (0.0%) with p-value = 0.010 Conclusion No significant difference was found between both groups regarding modified Vesikari scale score (MVS) at different times of measurement. Diarrhea was more prevalent in multiple doses of ondansetron than single dose as a side effect.