Comparative Efficacy and Safety of Intramuscular Versus Oral Ondansetron in Enhancing Oral Rehydration Therapy among Children with Acute Diarrhea

Background: Vomiting is a common and distressing symptom in paediatric acute diarrhea that significantly affects the success of oral rehydration therapy.Ondansetron, a 5-HT receptor antagonist, has established efficacy in reducing vomiting and improving ORT tolerance.However, limited data exist comparing the intramuscular and oral routes of administration, particularly in situations where oral intake may be compromised.Methods: In this single-blind, randomised clinical trial conducted at a tertiary care paediatric emergency department, 100 children aged 1 to 10 years with acute diarrhoea, vomiting, and signs of moderate dehydration were randomly assigned to receive either oral or IM ondansetron at a dose of 0.2 mg/kg.ORT was initiated 30 minutes after drug administration.Results assessed included ORT tolerance, vomiting frequency at 30 minutes, 4 hours, and 48 hours post-intervention, intravenous fluid requirement, and adverse effects.Results: ORT was successful in 88% of children in the oral group compared to 74% in the IM group.Vomiting within the first 30 minutes occurred in 4% of the oral group and 10% of the IM group.Over 48 hours, vomiting persisted in 4% and 12% of patients.Adverse events such as headache, tachycardia, and diarrhoea were infrequent and comparable between the groups.No statistically significant differences were observed in clinical outcomes or side effects. Conclusions:The study has concluded that the children with acute diarrhea showed a wide age distribution and varying clinical severity, with moderate-to-severe vomiting episodes before medical referral.