Stomach flu affects almost all children aged under five years. Children with stomach flu have a higher risk of dehydration. The standard treatment for this illness comprises advice and the use of medicines to prevent dehydration. Ondansetron blocks the arousal of the vomiting centre in the brain, through which vomiting and nausea is reduced. It has already appeared effective in children who were admitted to the hospital with stomach flu. However, no research had yet been done into the effects of ondansetron in children sick from stomach flu who had visited their GP. In this study, the researchers looked into the effects of ondansetron on vomiting among 194 children who had presented to their GP with stomach flu and vomiting from December 2015 to January 2018. They also investigated the consequences of the prescription of ondansetron on medical and societal costs.
The results of this study show that the children who received a dose of ondansetron syrup had to vomit twice as less as the children who received standard treatment. This is important in preventing dehydration. In addition, the parents of children who received ondansetron were more satisfied with the treatment than the parents of children who received standard treatment. Furthermore, the results show that the children who received ondansetron were less likely to have to return to the GP. This led to a substantial reduction of medical costs.
Less work absence for parents
In addition to the effects of ondansetron on the clinical picture of the children, the researchers also looked into medical and societal costs. Through this study, they show that the total costs of treatment with ondansetron were a third lower than the costs of treatment without ondansetron. This reduction in costs was mainly caused by parents having to take work absence less often. To this end, the difference was highest for mothers. Children who received ondansetron recovered more quickly, meaning that their parents were able to get back to work sooner.
Change in practice
The thoroughly supervised prescription of ondansetron to children who were sick from stomach flu effectively prevented vomiting and lowered medical and societal costs. These results could be used to further improve the quality and efficacy of general practice medicine. A subsidy was previously granted to carry out this study by the ZonMw programme ‘Goed gebruik geneesmiddelen’ (Good use of medicine).
For the full publication in BJGP, see: Oral ondansetron for paediatric gastroenteritis in primary care: a randomised controlled trial | British Journal of General Practice