Vomiting Clinical Trial
Official title:
Oral Ondansetron vs Domperidone for Symptomatic Treatment of Vomiting During Acute Gastroenteritis in Children: Multicentre Randomized Controlled Trial
Vomiting in children with acute gastroenteritis is a major factor of failure of oral
rehydration therapy. Effective symptomatic treatment of vomiting would lead to an important
reduction in the use of Intravenous Fluid Therapy. Available evidence on symptomatic
treatment of vomiting shows the efficacy of the most recently registered molecule
(ondansetron) but a proper evaluation of antiemetics drugs largely used in clinical
practice, such as domperidone, is lacking.
The aim of this multicentre, double-blind randomized controlled trial is to compare the
efficacy of ondansetron and domperidone for the symptomatic treatment of vomiting in
children with acute gastroenteritis who have failed Oral Rehydration Therapy.
Vomiting in children with acute gastroenteritis (AG) is not only a direct cause of fluid
loss but it is also a major factor of failure of oral rehydration therapy (ORT). Physicians
who provide care to paediatric patients in the emergency department (ED) usually prescribe
intravenous fluid therapy (IVT) for mild or moderate dehydration when vomiting is the major
symptom. Thus, effective symptomatic treatment of vomiting would lead to an important
reduction in the use of IVT and, consequently, of the duration of hospital stay and of
frequency of hospital admission. Available evidence on symptomatic treatment of vomiting
shows the efficacy of the most recently registered molecule (ondansetron) but a proper
evaluation of antiemetics drugs largely used in clinical practice, such as domperidone, is
lacking.
The aim of this multicentre, double-blind randomized controlled trial conducted in
paediatric Emergency Departments is to compare the efficacy of ondansetron and domperidone
for the symptomatic treatment of vomiting in children with AG who have failed Oral
Rehydration Therapy.
The trial results would provide evidence on the efficacy of domperidone, which is largely
used in clinical practice despite the lack of proper evaluation and a controversial safety
profile, as compared to ondansetron, which is not yet authorized in Italy despite evidence
supporting its efficacy in treating vomiting. The trial results would contribute to a
reduction in the use of IVT and, consequently, in hospital admissions in children with AG.
The design of this RCT, which closely reflect current clinical practice in EDs, will allow
immediate transferability of results
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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