Time‐series Analysis of Ondansetron Use in Pediatric Gastroenteritis

Abstract

Ondansetron use has increased significantly and is associated with reductions in the use of intravenous rehydration, emergency department revisits, and length of stay. The selective use of ondansetron is associated with improved clinical outcomes.

Impact of Increasing Ondansetron Use on Clinical Outcomes in Children With Gastroenteritis

“…This would ensure adequate variation in ondansetron use and enable the establishment of a lag period, which facilitates the detection of a change in outcomes in timeseries designs. 10 Hospitalization was defined as admission to an observation (ie, short stay, 24 hours) or inpatient unit. For revisit outcomes, a 3-day window, generally accepted as an ED quality of care metric, 21 23 were used to assess the associations, at the hospital level, of ondansetron use category with the primary and secondary outcomes adjusting for potential confounding by observed baseline characteristics identified in bivariate analysis (ie, age, sex, race, season, admission time, prior visit for AGE, laboratory testing, diagnostic imaging, and rotavirus diagnosis), including quadratic terms when significant.…”

“…[8][9][10] Studies have demonstrated efficacy of ondansetron in children with mild to moderate dehydration who had initially failed ORT 9,11 and in those with multiple episodes of vomiting prior to ED presentation. 12 Although now administered to more than 50% of children with AGE in US EDs, 13 its administration is not recommended in guidelines endorsed by the American Academy of Pediatrics.…”

“…16 Although randomized clinical trials (RCTs) have demonstrated the efficacy (ie, the beneficial effects under optimal conditions) of ondansetron use, its clinical effectiveness (ie, the effects under real-world conditions) 17 has only been evaluated in a single-center study where use remained low. 10 Thus, we conducted a multicenter retrospective cohort study to determine whether increasing ondansetron administration to children with AGE is associated with a concomitant decline in IV rehydration use.…”

Prescripción de antieméticos en urgencias en niños con gastroenteritis aguda

“…Este cambio se ha debido a ensayos clínicos dónde se demostró resolución del estado nauseoso y una adecuada recuperación de su equilibrio hidroelectrolítico. [4][5][6] Asimismo, su administración no provocó efectos secundarios serios y redujo el costo de atención. [4][5][6] De los antieméticos probados el más estudiado ha sido el ondansetrón, 4 con el cual se ha reducido tanto la rehidratación endovenosa de 31% a 14% como la hospitalización de 97% a 25%, así como el tiempo de estancia intrahospitalaria a menos de un día.…”

Emergency Department Ondansetron Use in Children with Type 1 Diabetes Mellitus and Vomiting

“…As ondansetron use gradually increased in period 2, this period was considered an "intersection" segment, and such children were excluded from this portion of the analysis. 26 To assess consistency of data abstraction, 10% of charts were identified at random, using a random number generator (Microsoft Office Excel 2007, Redmond, Washington), and reviewed in a blinded fashion by a second reviewer (M.R. or J.L.).…”