Abstract
Objectives Ondansetron has been shown to decrease admission rate and the need for intravenous fluids among pediatric emergency department (ED) patients with acute gastroenteritis, but there is limited evidence regarding its use after ED discharge. This study describes prescribing patterns for ondansetron and assesses the effects of ondansetron home prescription on rate of return. Methods Data were gathered from the electronic health record on 2 separate but overlapping groups of patients seen in a pediatric ED from 2012 to 2014. The Gastroenteritis Group included all patients with a discharge diagnosis of gastroenteritis by International Classification of Diseases, Ninth Revision, code. The All Ondansetron Group included any child prescribed ondansetron at discharge. Patterns of ondansetron use and 3- and 7-day ED return rate were assessed for both groups. Discharge diagnosis was evaluated for the All Ondansetron Group. Results A total of 996 patients with acute gastroenteritis were identified during the study period. Of these, 76% received ondansetron in the ED, and 71% were discharged with prescriptions for ondansetron. Seven-day ED return rates were similar between groups (6% with prescription, 5% without, P = 0.66). A total of 2287 patients received home prescriptions for ondansetron. Fifty-four percent of these patients' discharge diagnoses were classed as gastrointestinal complaints, 14% other infectious conditions, 9% respiratory, and 4% injuries. Their return rate was 6%. There was wide variation in the number of doses prescribed. Conclusions Home-use ondansetron is widely prescribed in this urban academic pediatric ED for a variety of indications, without effect on 3- or 7-day ED return. Further prospective studies are necessary to determine the efficacy of this practice.
Original language | English (US) |
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Pages (from-to) | E120-E124 |
Journal | Pediatric Emergency Care |
Volume | 36 |
Issue number | 3 |
DOIs | |
State | Published - Mar 1 2020 |
Bibliographical note
Funding Information:From the *Department of Pediatrics, University of Minnesota, Minneapolis, MN; †Department of Pediatrics, University of California, Davis, Sacramento, CA; and ‡Clinical and Translational Science Institute/Biostatistical Design and Analysis Center, University of Minnesota, Minneapolis, MN. Disclosure: Scott Lunos' work was supported in part by grant number UL1TR000114 from the National Center for Advancing Translational Sciences of the National Institutes of Health. For the remaining authors, no conflicts of interest were declared. The use of ondansetron discussed in this investigation is off label. Reprints: Marissa A. Hendrickson, MD, Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Minnesota Medical School, M654 East Bldg, 2450 Riverside Ave, Minneapolis, MN 55454 (e‐mail: mhendric@umn.edu). Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved. ISSN: 0749-5161
Publisher Copyright:
© Wolters Kluwer Health, Inc. All rights reserved.
Keywords
- discharge
- gastroenteritis
- home prescription
- ondansetron