Comparison of the Effectiveness of Ondansetron and Domperidone in Cessation of Vomiting in Children Presenting With Acute Gastroenteritis: A Meta-Analysis

Abstract

Acute gastroenteritis is one of the common diseases of childhood. Dehydration is the most frequent consequence of acute gastroenteritis, and vomiting is the most distressing clinical manifestation. Various anti-emetic agents are used in practice to control vomiting. However, not all anti-emetic agents are safe and effective. This meta-analysis aims to compare the effectiveness of ondansetron and domperidone in the cessation of vomiting in children with acute gastroenteritis. The current meta-analysis was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search strategy was developed to identify prospective studies that compared the effectiveness of ondansetron and domperidone in the cessation of vomiting in children with acute gastroenteritis. The primary outcome was the number of children in whom there was a cessation of vomiting. The secondary outcomes included a number of children who required an additional dose of the assigned anti-emetic and the number of children who required intravenous rehydration therapy. Overall, seven randomized trials were included in the current meta-analysis. The pooled sample size of enrolled patients was 1,262, of which 639 patients were randomized to the ondansetron group and 623 were randomized to the domperidone group. In the ondansetron group, a higher number of children experienced cessation of vomiting (risk ratio [RR]: 1.22, 95% CI: 1.08-1.37, p-value=0.002), a lower proportion of children needed an additional dose of the assigned anti-emetic (RR=0.50, 95% CI: 0.33-0.77, p-value=0.002), and a lower number of children received intravenous rehydration (RR: 0.37, 95% CI: 0.16-0.83, p-value=0.02) as compared to domperidone group. Compared to domperidone, ondansetron was found to have better efficiency in aiming cessation of vomiting in children with gastroenteritis.

Comparative Analysis of Oral Ondansetron, Metoclopramide, and Domperidone for Managing Vomiting in Children With Acute Gastroenteritis

“…By reducing emesis, ondansetron may also promote oral fluid intake, potentially decreasing the requirement for hospitalization and intravenous rehydration [24]. Previous studies administered ondansetron, domperidone, and metoclopramide orally, with the oral disintegrating form of ondansetron offering a simpler and less-invasive administration method, particularly advantageous for vomiting children and those receiving outpatient care [9,16,[25][26][27][28][29][30]. Furthermore, our study also delved into the safety profile of these antiemetic medications.…”

Diagnósticos retrasados y administración de ondansetron en el tratamiento de los vómitos en urgencias pediátricas

“…Se ha demostrado que prescribir rehidratación oral puede reducir el ingreso (3) hospitalario hasta en un 45% . El tratamiento con ondansetron en niños con gastroenteritis aguda y vómitos además de ser más efectivo que la domperidona, mejora la eficacia de la rehidratación (4)(5)(6) oral . Sin embargo, un estudio reciente encontró que la administración de ondansetron como tratamiento farmacológico de los vómitos en pacientes en la atención primaria puede enmascarar patologías que (7) luego en la reconsulta necesitaron hospitalización .…”