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Maybe Ondansetron Rx Does Reduce Bouncebacks in Kids

July 21, 2020

Written by Vivian Lei

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In this retrospective study, an ondansetron prescription was associated with decreased 72-hour return visit rates for children with vomiting or acute gastroenteritis and did not appear to mask any alternative diagnosis.

Why does this matter?
Ondansetron is a commonly prescribed medication for children presenting to the ED with vomiting. This study addresses whether an outpatient prescription at discharge affects rates of return to the ED for this group of patients. Previous smaller studies did not show reduction in ED bouncebacks with ondansetron. What does this massive study show?

Stay home…with ondansetron
This was a retrospective cohort study of pediatric patients aged 6 months to 18 years old who presented to an ED or urgent care with discharge diagnosis of gastroenteritis or vomiting. A total of 82,139 patients were included, of which 7.9% received an IV fluid bolus, 55.1% received ondansetron in the ED, and 13.4% received a prescription for ondansetron at discharge. Within a 72-hour period, 3851 patients (4.7%) returned to the ED. Receiving a prescription for ondansetron significantly reduced the odds of a return visit (adjusted OR 0.84). Factors that increased odds of a return visit included younger age, receiving intravenous fluids or ondansetron at the index visit, and having a radiologic study performed at the index visit. A prescription for ondansetron did not increase the risk of patients’ returning with an alternative diagnosis (e.g appendicitis or intussusception).

Ondansetron Prescription Is Associated With Reduced Return Visits to the Pediatric Emergency Department for Children With Gastroenteritis. Ann Emerg Med. 2020 May 26. pii: S0196-0644(20)30262-6. doi: 10.1016/j.annemergmed.2020.04.012. [Epub ahead of print]

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