Use of Ondansetron for Pediatric Gastroenteritis in the Pediatric Emergency Department: An Evaluation of the Pediatric Emergency Care Applied Research Network Registry
Abstract
OBJECTIVE
To evaluate the association of emergency department (ED) ondansetron with hospitalization with acute gastroenteritis (AGE) in children.
METHODS
We conducted a retrospective study using the PECARN Registry of children with AGE. Within a sample matched on vital signs, demographics, clinical severity, imaging performance, and intravenous fluids provision, we used conditional logistic regression to assess associations between administration of ondansetron and hospitalization. We compared rates of 7-day return visits with significant diagnoses between children who did and who did not receive ondansetron on their initial encounter.
RESULTS
We included 543,541 encounters, of which ondansetron was administered in 39.7%. After matching, hospital admission occurred in 11.8% and 17.7% of children who did and did not receive ondansetron, respectively, with standardized mean differences <0.1. Ondansetron was negatively associated with hospitalization (OR: 0.61, 95% CI: 0.60-0.63). Children given ondansetron on their index visit had a higher percentage of 7-day return visits with appendicitis (absolute percentage difference, +0.05%, 95% CI: +0.03%, +0.07%), but a lower percentage of return visits with sepsis or bacteremia (-0.03%, 95% CI: -0.05%, -0.01%) compared with children not given ondansetron on their index visit.
CONCLUSIONS
Children receiving ondansetron for AGE in the ED had an ∼40% lower odds of hospitalization. While appendicitis was diagnosed more frequently within 7…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 7 participants or records.
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