1–6 Yaş Arası Çocuklarda Akut Gastroenterit Nedeniyle Oral Ondansetron Kullanımının Yeniden Başvuru ve Hastane Yatışlarına Etkisi: Retrospektif Kohort Çalışması
Yıl 2026,
Cilt: 28 Sayı: 1
,
44
-
48
,
27.04.2026
Aydın Çelik
,
Mahmut Esat Tuluce
Nihat Cem Celebi
Öz
Amaç: Akut gastroenterit, özellikle çocukluk çağında dünya genelinde önemli bir halk sağlığı sorunu olmaya devam etmektedir ve sağlık sistemleri üzerinde klinik ve ekonomik bir yük oluşturmaktadır. Ondansetron, seçici bir serotonin 5-HT3 reseptör antagonisti olup başlangıçta kemoterapiye bağlı bulantı ve kusmanın önlenmesi amacıyla geliştirilmiştir. Son yıllarda, oral ondansetronun çocuklarda akut gastroenterit semptomlarının kontrolünde kullanılabileceğine dair çalışmalar mevcuttur. Bu çalışmanın amacı, 1–6 yaş arası akut gastroenteritli çocuklarda oral ondansetron kullanımının acil servise yeniden başvuru ve hastaneye yatış oranları ile ilişkisini değerlendirmektir.
Gereç ve Yöntemler: Bu retrospektif kohort çalışması, Ocak 2022–Kasım 2024 tarihleri arasında Acıbadem Maslak Hastanesi Çocuk Acil Servisi’ne akut gastroenterit bulguları ile başvuran 339 hastayı kapsamaktadır. Hastalar, oral ondansetron tedavisi alan (n=162) ve antiemetik tedavi almayan kontrol grubu (n=177) olmak üzere iki gruba ayrılmıştır. Demografik ve klinik veriler elektronik hasta kayıtlarından elde edilmiştir. Acil servise yeniden başvuru, hastaneye yatış ve intravenöz sıvı gereksinimi oranları karşılaştırılmıştır.
Bulgular: Oral ondansetron uygulanan grupta acil servise yedi gün içinde yeniden başvuru oranı %14 iken, kontrol grubunda bu oran %21 olarak saptanmıştır (p=0,036). Hastaneye yatış oranı ondansetron grubunda %2, kontrol grubunda %10 olarak bulunmuştur (p<0,001). İntravenöz sıvı gereksinimi oranı ondansetron grubunda daha düşük saptanmıştır.
Sonuç: Bu çalışmada, oral ondansetron kullanımının akut gastroenteritli çocuklarda bazı klinik sonuçlarla ilişkili olduğu görülmüştür. Oral ondansetron, seçilmiş hasta gruplarında yardımcı bir tedavi seçeneği olarak değerlendirilebilir.
Etik Beyan
Bu çalışmanın protokolü, 12 Haziran 2025 tarihinde 2025-09/362 karar numarası ile Acıbadem Maslak Hastanesi Etik Kurulu tarafından onaylanmıştır. Çalışma, Helsinki Bildirgesi’nde belirtilen etik ilkeler doğrultusunda yürütülmüştür.
Teşekkür
Yazarlar, veri toplama ve dokümantasyon sürecindeki desteklerinden dolayı Acıbadem Maslak Hastanesi Çocuk Acil Servisi çalışanlarına teşekkür eder.
Kaynakça
-
Graves NS. Acute gastroenteritis. Prim Care. 2013;40(3):727-741.
-
Freedman SB, Adler M, Seshadri R, Powell EC. Oral ondansetron for gastroenteritis in a pediatric emergency department. N Engl J Med. 2006;354(16):1698-1705.
-
Chow CM, Leung AKC, Hon KL. Acute gastroenteritis: from guidelines to real life. Clin Exp Gastroenterol. 2010;15(3):97-112.
-
Sharia MA, Aron JH, Anne ER, et al. Global prevalence of norovirus in cases of gastroenteritis: a systematic review and meta-analysis. Lancet Infect Dis. 2014;14(8):725-730.
-
Orhan Ö, Bulut M. Evaluation of pediatric patients admitted for acute gastroenteritis. Eur J Res. 2023;9(6):1392-1397.
-
Lifschitz C, Kozhevnikov O, Oesterling C, Anbad A, Walker S. Acute gastroenteritis—changes to the recommended original oral rehydrating salts: a review. Front Pediatr. 2023;11:1294490.
-
Aghsaeifard Z, Heidari G, Alizadeh R. Understanding the use of oral rehydration therapy: a narrative review from clinical practice to main recommendations. Health Sci Rep. 2022;5(5):e827.
-
Mengistie B, Berhane Y, Worku A. Predictors of oral rehydration therapy use among under-five children with diarrhea in Eastern Ethiopia: a community-based case control study. BMC Public Health. 2012;12:1029-1037.
-
Roslund G, Hepps TS, McQuillen KK. The role of oral ondansetron in children with vomiting as a result of acute gastritis/gastroenteritis who have failed oral rehydration therapy: a randomized controlled trial. Ann Emerg Med. 2008;52(1):22-29.
-
Rerksuppaphol S, Rerksuppaphol L. Efficacy of intravenous ondansetron to prevent vomiting episodes in acute gastroenteritis: a randomized, double-blind, controlled trial. Pediatr Rep. 2010;2(2):e17-e25.
-
Freedman SB, Soofi SB, Willan AR, et al. Oral ondansetron administration to nondehydrated children with diarrhea and associated vomiting in emergency departments in Pakistan: a randomized controlled trial. Ann Emerg Med. 2019;73(3):255-265.
-
Das JK, Kumar R, Salam RA, Freedman S, Bhutta ZA. The effect of antiemetics in childhood gastroenteritis. BMC Public Health. 2013;13(3):1-10.
-
Marchetti F, Maestro A, Rovere F, et al. Oral ondansetron versus domperidone for symptomatic treatment of vomiting during acute gastroenteritis in children: multicentre randomized controlled trial. BMC Pediatr. 2011;11:15.
-
Singh K, Jain A, Panchal I, et al. Ondansetron-induced QT prolongation among various age groups: a systematic review and meta-analysis. Egypt Heart J. 2023;75(56):1-10.
-
Chan AK, Leung AK, Leung AA. Ondansetron use in children: a review of concerns regarding long-term safety. J Pediatr Pharmacol Ther. 2019;24(2):72-77.
-
DeCamp LR, Byerley JS, Doshi N, Steiner MJ. Use of antiemetic agents in acute gastroenteritis: a systematic review and meta-analysis. Arch Pediatr Adolesc Med. 2008;162(9):858-865.
-
Mahram M, Oveisi S, Darabi M. The effect of ondansetron on decreasing the hospitalization rate in children with gastroenteritis and recurrent vomiting. Iran Red Crescent Med J. 2020;22(7):e42907.
-
Benary D, Lozano JM, Higley R, Lowe D. Ondansetron prescription is associated with reduced return visits to the pediatric emergency department for children with gastroenteritis. Ann Emerg Med. 2020;76(5):625-634.
-
Bodur İ, Öztürk B, Göktuğ A, et al. The effect of intramuscular ondansetron treatment on prognosis in patients diagnosed with acute gastroenteritis. J Pediatr Emerg Intensive Care Med. 2023;10(2):117-121.
-
Carter B, Fedorowicz Z. Antiemetic treatment for acute gastroenteritis in children: an updated Cochrane systematic review with meta-analysis and mixed treatment comparison in a Bayesian framework. BMJ Open. 2012;2(4):e000622.
EFFECTIVENESS OF ORAL ONDANSETRON ON REVISITS AND HOSPITAL ADMISSIONS IN CHILDREN AGED 1–6 YEARS WITH ACUTE GASTROENTERITIİS: A RETROSPECTIVE COHORT STUDY
Yıl 2026,
Cilt: 28 Sayı: 1
,
44
-
48
,
27.04.2026
Aydın Çelik
,
Mahmut Esat Tuluce
Nihat Cem Celebi
Öz
Objective: Acute gastroenteritis remains an important public health problem worldwide, particularly in childhood, and continues to impose a clinical and economic burden on healthcare systems. Ondansetron is a selective serotonin 5-HT3 receptor antagonist that was initially developed for the prevention of chemotherapy-induced nausea and vomiting. In recent years, oral ondansetron has been increasingly used in children with acute gastroenteritis. The aim of this study was to evaluate the association between oral ondansetron use and emergency department revisit and hospital admission rates in children aged 1–6 years with acute gastroenteritis.
Material and Methods:This retrospective cohort study included 339 children aged 1–6 years who presented with symptoms of acute gastroenteritis to the Pediatric Emergency Department of Acibadem Maslak Hospital between January 2022 and November 2024. Patients were divided into two groups: those who received oral ondansetron (n=162) and those who did not receive any antiemetic treatment (control group, n=177). Demographic and clinical data were obtained from electronic medical records. Rates of emergency department revisits, hospital admissions, and intravenous fluid requirement were compared between the groups.
Results:The rate of emergency department revisit within 7 days was 14% in the ondansetron group and 21% in the control group (p=0.036). Hospital admission rates were lower in the ondansetron group compared with the control group (2% vs. 10%, p<0.001). In addition, the requirement for intravenous fluid therapy was lower among patients who received oral ondansetron.
Conclusion:The findings of this study suggest that oral ondansetron use is associated with lower hospital admission and intravenous fluid requirement rates in children with acute gastroenteritis. Oral ondansetron may be considered as an adjunctive treatment option in selected pediatric patients.
Etik Beyan
The protocol of this study was approved by the Ethics Committee of Acıbadem Maslak Hospital on June 12, 2025, with decision number 2025-09/362. The study was conducted in accordance with the principles outlined in the Helsinki Declaration.
Teşekkür
The authors would like to thank the staff of the Pediatric Emergency Department at Acıbadem Maslak Hospital for their support during data collection and documentation.
Kaynakça
-
Graves NS. Acute gastroenteritis. Prim Care. 2013;40(3):727-741.
-
Freedman SB, Adler M, Seshadri R, Powell EC. Oral ondansetron for gastroenteritis in a pediatric emergency department. N Engl J Med. 2006;354(16):1698-1705.
-
Chow CM, Leung AKC, Hon KL. Acute gastroenteritis: from guidelines to real life. Clin Exp Gastroenterol. 2010;15(3):97-112.
-
Sharia MA, Aron JH, Anne ER, et al. Global prevalence of norovirus in cases of gastroenteritis: a systematic review and meta-analysis. Lancet Infect Dis. 2014;14(8):725-730.
-
Orhan Ö, Bulut M. Evaluation of pediatric patients admitted for acute gastroenteritis. Eur J Res. 2023;9(6):1392-1397.
-
Lifschitz C, Kozhevnikov O, Oesterling C, Anbad A, Walker S. Acute gastroenteritis—changes to the recommended original oral rehydrating salts: a review. Front Pediatr. 2023;11:1294490.
-
Aghsaeifard Z, Heidari G, Alizadeh R. Understanding the use of oral rehydration therapy: a narrative review from clinical practice to main recommendations. Health Sci Rep. 2022;5(5):e827.
-
Mengistie B, Berhane Y, Worku A. Predictors of oral rehydration therapy use among under-five children with diarrhea in Eastern Ethiopia: a community-based case control study. BMC Public Health. 2012;12:1029-1037.
-
Roslund G, Hepps TS, McQuillen KK. The role of oral ondansetron in children with vomiting as a result of acute gastritis/gastroenteritis who have failed oral rehydration therapy: a randomized controlled trial. Ann Emerg Med. 2008;52(1):22-29.
-
Rerksuppaphol S, Rerksuppaphol L. Efficacy of intravenous ondansetron to prevent vomiting episodes in acute gastroenteritis: a randomized, double-blind, controlled trial. Pediatr Rep. 2010;2(2):e17-e25.
-
Freedman SB, Soofi SB, Willan AR, et al. Oral ondansetron administration to nondehydrated children with diarrhea and associated vomiting in emergency departments in Pakistan: a randomized controlled trial. Ann Emerg Med. 2019;73(3):255-265.
-
Das JK, Kumar R, Salam RA, Freedman S, Bhutta ZA. The effect of antiemetics in childhood gastroenteritis. BMC Public Health. 2013;13(3):1-10.
-
Marchetti F, Maestro A, Rovere F, et al. Oral ondansetron versus domperidone for symptomatic treatment of vomiting during acute gastroenteritis in children: multicentre randomized controlled trial. BMC Pediatr. 2011;11:15.
-
Singh K, Jain A, Panchal I, et al. Ondansetron-induced QT prolongation among various age groups: a systematic review and meta-analysis. Egypt Heart J. 2023;75(56):1-10.
-
Chan AK, Leung AK, Leung AA. Ondansetron use in children: a review of concerns regarding long-term safety. J Pediatr Pharmacol Ther. 2019;24(2):72-77.
-
DeCamp LR, Byerley JS, Doshi N, Steiner MJ. Use of antiemetic agents in acute gastroenteritis: a systematic review and meta-analysis. Arch Pediatr Adolesc Med. 2008;162(9):858-865.
-
Mahram M, Oveisi S, Darabi M. The effect of ondansetron on decreasing the hospitalization rate in children with gastroenteritis and recurrent vomiting. Iran Red Crescent Med J. 2020;22(7):e42907.
-
Benary D, Lozano JM, Higley R, Lowe D. Ondansetron prescription is associated with reduced return visits to the pediatric emergency department for children with gastroenteritis. Ann Emerg Med. 2020;76(5):625-634.
-
Bodur İ, Öztürk B, Göktuğ A, et al. The effect of intramuscular ondansetron treatment on prognosis in patients diagnosed with acute gastroenteritis. J Pediatr Emerg Intensive Care Med. 2023;10(2):117-121.
-
Carter B, Fedorowicz Z. Antiemetic treatment for acute gastroenteritis in children: an updated Cochrane systematic review with meta-analysis and mixed treatment comparison in a Bayesian framework. BMJ Open. 2012;2(4):e000622.