WEDNESDAY, April 19, 2006 (HealthDay News) -- Children with stomach bugs can get dehydrated very quickly, and sometimes need intravenous fluids to stay well.
But a new study finds that by giving one dose of an anti-vomiting medication called ondansetron, doctors could cut the need for IV rehydration by more than half.
"Vomiting and IV insertion often go hand in hand," explained Dr. Stephen Freedman, an assistant professor of pediatrics at The Hospital for Sick Children in Toronto, and the lead author of the study.
"We always try oral rehydration first and most children can be treated with it. Adding ondansetron allows [oral rehydration] to be more successful and reduces the need for IV insertion," he said.
Results of the study are published in the April 20 issue of the New England Journal of Medicine.
Each year, there are more than 1.5 million pediatric outpatient visits in the United States due to gastroenteritis, which is more popularly known as the stomach flu. About 200,000 American children are hospitalized annually from complications of gastroenteritis, according to background information in the study. When children are vomiting frequently, doctors will often choose to use IV fluids to prevent or correct dehydration, because it's difficult for kids to keep oral fluids down, according to the study.
For the study, the researchers recruited 215 children treated in the emergency department at Children's Memorial Hospital in Chicago for gastroenteritis. They ranged in age from 6 months to 10 years.
The children were randomly assigned to one of two groups -- the first group received ondansetron in the form of an orally disintegrating tablet, and the second group received a placebo tablet. If they threw up within 15 minutes after taking the pill, they were given a second dose.
The youngsters who received the medication were significantly less likely to vomit (14 percent) than those who received the placebo (35 percent). They also vomited less often than children who received no medication.
Only 14 percent of the treated children needed an IV insertion, while 31 percent of the kids who weren't treated with ondansetron did. The treated group also had a slightly shorter length of stay in the emergency department -- about 12 percent less.
Rates of hospitalization and the number of children who returned to the emergency room didn't vary significantly between the groups, however.
But Dr. Paul Harlow, a private practice pediatrician and a pediatric hematologist/oncologist at Hackensack University Medical Center in New Jersey, said he wasn't convinced that ondansetron made a big difference in the children studied.
"The kids on ondansetron were more likely to take fluids, but they only averaged about an ounce and a half more fluids. If that made a significant difference, the number of kids hospitalized and coming back would be significantly less," he said.
According to Freedman, the number of children who had to be hospitalized was so small -- 4 percent in the treatment group and 5 percent in the placebo group -- that there wasn't enough statistical evidence to assess whether ondansetron could make a difference in hospitalization rates. As to the number of children coming back, he said he wasn't surprised, because they were only given one dose of ondansetron and when it wore off, the vomiting would return.
Harlow said ondansetron "does have some effect," and that this was "an intriguing, initial study."
He added that it would be interesting to see if the drug could help more if it were given earlier in the course of the illness, especially since it appears to have few side effects. And, he pointed out that getting immunized against rotavirus -- a common cause of gastroenteritis -- could decrease the risk of getting sick in the first place.
Freedman said the bottom line is that "children don't have to feel miserable. There is something out there that can help them feel better and avoid IVs."
More information
To learn more about preventing dehydration in children, visit KidsHealth.org.
