Martínez-Hernández A, Martina-Luna M, Rendón-Macías ME, Iglesias-Leboreiro J, Bernárdez-Zapata I, Jiménez-Rivera NJJ

Language: Spanish
References: 13
Page: 147-150
PDF size: 177.74 Kb.

ABSTRACT

Introduction: Vomiting limits oral rehydration in dehydrated pediatric patients with acute gastroenteritis and increases the probability of being hospitalized. Objective: To analyze the impact on the hospitalization rate when an antiemetic is administered in children treated in a private emergency service. Material and methods: Analytical cross-sectional study. Patients younger than 18 years-old, who evaluated in the emergency department for acute gastroenteritis with the presence of vomits treated with and without antiemetic (ondansetron, dimenhydrinate or meclozine / pyridoxine) were included. Hospitalization rate for oral intolerance and dehydration was analyzed. Results: Of 500 patients, 273 (54.6%) received antiemetic. The main prescribed antiemetic was ondansetron (95%). Use of antiemetic reduced by 19.2% (95% CI 10.7 to 27.4 p ‹0.0001) the hospitalization rate (76.9% versus 51.2% without use). There were no differences in time spent in the emergency room. All patients were discharged with good hydration status. Conclusions: In this study, use of antiemetics for the control of vomiting in children with gastroenteritis was high; it is possible that the use of antiemetics helps rehydration.

REFERENCES

1. Consejo de Salubridad General. Prevención, diagnóstico y tratamiento de la diarrea aguda en niños de dos meses a cinco años en el primero y segundo nivel de atención. Guía de Práctica Clínica, México, Secretaría de Salud, 2008.

2. National Collaborating Centre for Women’s and Children’s Health, Commissioned by the National Institute for Health and Clinical Excellence. Diarrhoea and vomiting caused by gastroenteritis, diagnosis, assessment and management in children younger than 5 year. Clinical Guideline. 2009.

3. Centers for Disease Control and Prevention. Managing acute gastroenteritis among children: oral rehydration, maintenance, and nutritional therapy. MMWR. 2003; 52(RR-16): 4-5.

4. Rutman L, Klein EJ, Brown J. Clinical pathway produces sustained improvement in acute gastroenteritis care. Pediatrics. 2017; 140(3): e20164310.

5. Carter B, Fedorowicz Z. Antiemetic treatment for acute gastroenteritis in children: an updated Cochrane systematic review with meta-analysis and mixed treatment comparison in a Bayesian framework. BMJ Open. 2012; 2: e000622.

6. Freedman SB, Tung C. Time-series analysis of ondansetron use in pediatric gastroenteritis. J Pediatr Gastroenterol Nutr. 2012; 54: 381-386.

7. Freedman SB, Adler M, Seshadri R, Powell EC. Oral ondansetron for gastroenteritis in a pediatric emergency department. N Engl J Med. 2006; 354: 1698-1705.

8. De Camp LR, Byerley JS, Doshi N, Steiner MJ. Use of antiemetic agents in acute gastroenteritis: a systematic review and meta-analysis. Arch Pediatr Adolesc Med. 2008; 162(9): 858-865.

9. Ramsook C, Sahagun-Carreon I, Kozinetz CA, Moro-Sutherland D. A randomized clinical trial comparing oral ondansetron with placebo in children with vomiting from acute gastroenteritis. Ann Emerg Med. 2002; 39(4): 397-403.

10. Pfeil N, Uhlig U, Kostev K. Antiemetic medications in children with presumed infectious gastroenteritis-pharmacoepidemiology in Europe and Northern America. J Pediatr. 2008; 153 (5): 659-662.

11. Hernández LI, Sánchez CN, Reyes HU. Prescripción de antieméticos y antiespasmódicos en los niños con diarrea aguda. Rev Mex Ped. 2012; 80: 223-226.

12. Mackenzie A, Barnes G. Randomized controlled trial comparing oral and intravenous rehydration therapy in children with diarrhea. BMJ. 1991; 303(6799): 393-396.

13. Nalin DR, Cash RA. 50 years of oral rehydration therapy: the solution is still simple. Lancet. 2018; 392(10147): 536-538.