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Acute gastroenteritis generally is self-limiting, with oral rehydration being the mainstay of management. However, persistent vomiting predicts failure of oral rehydration in children. Emergency department studies have demonstrated the efficacy of oral ondansetron in limiting vomiting and improving oral rehydration (NEJM JW Gen Med May 15 2006 and N Engl J Med 2006; 354:1698), but whether it has a role in primary care management is unclear.
Researchers randomized 194 Dutch children (age range, 6 months–6 years) with acute gastroenteritis and persistent vomiting (≥4 episodes in previous 24 hours) who were seen at after-hours primary care clinics to either standard care (oral rehydration instructions only) or standard care plus a single 0.1 mg…