Abstract

Research Article

An Audit on the implementation of administering Ondansetron in children with acute gastroenteritis and its effect on admission rate

Saskia D’Sa*, Ahad Hussain, Mushtaq Hussain, Zahir Afridi, John Twomey and Irfan Ahmed

Published: 25 March, 2021 | Volume 4 - Issue 1 | Pages: 023-026

Acute gastroenteritis (AGE) is a common presenting complaint in paediatrics. Most often, the reason for admission into hospital is to initiate intravenous rehydration in patients with severe dehydration and inability to tolerate oral intake. We found that Ondansetron acts as a potent antiemetic to support an increased number of children receiving oral hydration, and subsequently leading to decreased rates of admission. This study aims to audit the use of Ondansetron to Oral Rehydration Therapy (ORT) on children with acute gastroenteritis, and its effect on admission rates from the emergency department in University Hospital, Limerick (UHL). Data collected over a 3-month period from June to August 2017 in which Ondansetron was not used was compared to another 3-month period when Ondansetron was used. Several outcomes were measured including admission to hospital.

The rate of admission decreased by 15% [26/74 (35%) in 2017 to 16/81 (20%) in 2019 p = 0.22]. 81 patients received Ondansetron, of which 79% were successfully rehydrated orally. The administration of Ondansetron reduced the need for intravenous fluids and hospital admission overall in these children with AGE. This reduction ultimately accounted for lower costs incurred by the Health Services Executive per patient, and also suggested the anti-emetic use as a cost effective measure for managing and treating patients with AGE.

Read Full Article HTML DOI: 10.29328/journal.japch.1001025 Cite this Article Read Full Article PDF

References

  1. Rokach A. Psychological, emotional and physical experiences of hospitalized children. Clin Case Rep Rev. 2016; 2: 399-401.
  2. Ryan MG, Edwards MS, Torchia MM. Acute viral gastroenteritis in children in resource-rich countries. UpToDate. 2020.
  3. Hartman S, Brown E, Loomis E, Russell HA. Gastroenteritis in Children. American Academy of Family Physicians. https://www.aafp.org/afp/2019/0201/p159.pdf
  4. World Health Organization. The Treatment of Diarrhoea - A Manual for Physicians and other senior health care workers. Department of Child and Adolescent Health Development. 2005. https://apps.who.int/iris/bitstream/handle/10665/43209/9241593180.pdf?sequence=1
  5. Dioralyte Relief Blackcurrant Sachets P. (n.d.). 2020. https://www.medicines.org.uk/emc/product/274/smpc
  6. Sturm JJ, Hirsh DA, Schweickert A, Massey R, Simon HK. Ondansetron use in the Pediatric Emergency Department and effects on hospitalisation and return rates: are we masking alternate diagnoses? Ann Emerg Med. 2010; 55: 415-422. PubMed: https://pubmed.ncbi.nlm.nih.gov/20031265/
  7. Das JK, Kumar R, Salam RA, Freedman S, Bhutta ZA. The effect of antiemetics in childhood gastroenteritis. BMC public health. 2013; 13: S9. PubMed: https://www.ncbi.nlm.nih.gov/books/NBK174828/
  8. Health Services Executive. 2020. Hospital Charges- Acute Hospitals Division. Retrieved from. https://www.hse.ie/eng/about/who/acute-hospitals-division/patient-care/hospital-charges/
  9. Marchetti F, Bonati M, Maestro A, Zanon D, Rovere F, et al. Oral Ondansetron versus Domperidone for Acute Gastroenteritis in Pediatric Emergency Departments: Multicenter Double Blind Randomized Controlled Trial. PloS One. 2016; 11: e0165441. PubMed: https://pubmed.ncbi.nlm.nih.gov/27880811/
  10. Mullarkey C, Crowley E, Martin C. The addition of ondansetron to a oral rehydration protocol for children with acute gastroenteritis. Irish Med J. 2013; http://hdl.handle.net/10147/303572
  11. World Health Organization. Oral Rehydration Salts - Production of the new ORS. Department of Child and Adolescent Health and Development (CAH) World Health Organization. 1998. https://apps.who.int/iris/bitstream/handle/10665/69227/WHO_FCH_CAH_06.1.pdf?sequence=1

Figures:

Figure 1

Figure 1

Figure 1

Figure 2

Figure 1

Figure 3

Similar Articles

Recently Viewed

Read More

Most Viewed

Read More