Impact of increasing ondansetron use on clinical outcomes in children with gastroenteritis
Abstract
IMPORTANCE: Ondansetron hydrochloride use in children with gastroenteritis is increasing rapidly; however, little is known about its impact on outcomes.
OBJECTIVE: To determine whether increasing emergency department ondansetron use has resulted in a reduction in intravenous rehydration rates.
DESIGN, SETTING, AND PARTICIPANTS: Retrospective observational analysis of eligible visits included in the Pediatric Health Information System administrative database. Eligible institutions included 18 emergency departments geographically distributed across the United States, and participants included 804,000 patients aged 0 to 18 years who were diagnosed as having gastroenteritis in an emergency department at an eligible participating institution between January 1, 2002, and December 31, 2011.
INTERVENTIONS: The presence or absence of oral ondansetron administration was identified for each patient through database review. Visits were categorized based on institutional ondansetron use: low (25%).
MAIN OUTCOMES AND MEASURES: We conducted hospital-level analyses of the associations between ondansetron use and 3 outcomes: intravenous rehydration (primary), hospitalization, and emergency department revisits within 3 days. Time-series regression models were used, adjusting for demographic characteristics, laboratory testing, diagnostic imaging, and rotavirus infection.
RESULTS: A total of 804,000 eligible patient visits were identified. Oral ondansetron use increased from a median…
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