Antiemetic Use for Acute Gastroenteritis in Children

Abstract

Antiemetic use among children with acute gastroenteritis is common and adverse effects seem to be rare.

Provision of Pneumococcal Prophylaxis for Publicly Insured Children With Sickle Cell Disease

“…Medicaid and vital records data from both states have been used extensively to conduct health services research in children. [13][14][15][16][17][18] The Medicaid programs in Tennessee and Washington have similar regulations for maximum prescription length and refills. Like new prescriptions, renewals generate Medicaid claims in both states.…”

Prescription and cost-analysis of antiemetic medication use in pediatric wards: a prospective observational study

“…6 At least half of all physicians caring for children with gastroenteritis report prescribing antiemetic agents and 10% of children with gastroenteritis who undergo outpatient care fill a prescription for an antiemetic drug. 7,8 Antiemetic drugs are often used because vomiting is an unpleasant and a distressing symptom which can increase the likelihood of dehydration, electrolyte imbalance, pulmonary aspiration, and most importantly the need for intravenous hydration or hospitalization. 8,9 The American Academy of Pediatrics (AAP), Centers for Disease Control and Prevention (CDC), European Society for Pediatric Gastroenterology and Nutrition, and the World Health Organization (WHO) all strongly support the use of oral rehydration therapy as the firstline therapy for the treatment of acute gastroenteritis, except in cases of severe dehydration.…”

“…7,8 Antiemetic drugs are often used because vomiting is an unpleasant and a distressing symptom which can increase the likelihood of dehydration, electrolyte imbalance, pulmonary aspiration, and most importantly the need for intravenous hydration or hospitalization. 8,9 The American Academy of Pediatrics (AAP), Centers for Disease Control and Prevention (CDC), European Society for Pediatric Gastroenterology and Nutrition, and the World Health Organization (WHO) all strongly support the use of oral rehydration therapy as the firstline therapy for the treatment of acute gastroenteritis, except in cases of severe dehydration. 3,[10][11][12] Although treatment guidelines do not recommend antiemetic medications in children with Gastroenteritis related vomiting, their use seems to be rather common in clinical practice.…”

“…[15][16][17] Multiple medications have been used in an attempt to limit vomiting and facilitate oral rehydration but have not gained acceptance because of their limited success and high rates of complicating adverse effects. 8,18 Traditional antiemetics such as promethazine, prochlorperazine and metoclopramide have not gained acceptance, because of their limited success and high rates of complicating adverse effects that like extrapyramidal reactions, lethargy, respiratory depression and cardiac dysrhythmias. 7,8,18 Domperidone remains first line drug in children due to its good side effect profile.…”

“…8,18 Traditional antiemetics such as promethazine, prochlorperazine and metoclopramide have not gained acceptance, because of their limited success and high rates of complicating adverse effects that like extrapyramidal reactions, lethargy, respiratory depression and cardiac dysrhythmias. 7,8,18 Domperidone remains first line drug in children due to its good side effect profile.…”