Vomiting Clinical Trial
Official title:
Efficacy of Ondansetron on Vomiting Due to Acute Gastroenteritis in Pediatric During Winter
Acute gastroenteritis is a common disease especially in children. With bronchiolitis and
influenza, she participated widely in weight of winter epidemics that causes problems every
year our health care system, particularly in the pediatric emergency and inpatient since
they are the second leading cause of hospitalization in children. The main symptoms of viral
acute gastroenteritis are diarrhea and vomiting which exposes children to the risk of
sometimes severe dehydration, the most common cause of hospitalization. There is no specific
treatment for these infections. At most, there is a vaccine against severe rotavirus
diarrhea (Rotarix ® and RotaTeq ®), but does not yet official recommendations to use in
France. The treatment of acute gastroenteritis virus is symptomatic and is generally based
on the use of oral rehydration solutions (ORS) whose administration is limited by the
frequent presence of vomiting. Until now, no treatment has demonstrated its effectiveness on
vomiting due to acute gastroenteritis virus in children. Conventional anti-emetics, widely
prescribed, are ineffective in practice, very few studies in this indication and encumbered
side effects. Several drugs have long been used in children to fight against severe vomiting
associated with the administration of anti-cancer chemotherapy, such as granisetron (Kytril
®) and ondansetron (Zofren ®). The mechanism of action of these molecules is well known.
They act both on the enteric nervous system by blocking serotonin receptors. Several
placebo-controlled trials suggest that ondansetron is effective in reducing the number of
vomiting in children emergency consultant for acute gastroenteritis. However, the method
used in these tests and the number of children enrolled has not yet demonstrated the
efficacy of ondansetron on the number of admissions, the number of emergency and return the
cost / benefit ratio of this treatment. In addition, several studies reported the occurrence
of watery stools more frequently in children treated with the placebo group.
Evidence that ondansetron is well tolerated and effective for reducing the severity of
vomiting during acute gastroenteritis pediatrics winter could support the use of this
treatment in routine pediatric emergencies.
This study is a clinical trial, multicenter, controlled versus placebo whose main objective
is to evaluate the efficacy of ondansetron to decrease the intensity of vomiting in children
with acute gastroenteritis during winter emergencies Upon arrival to the emergency room
after signing. Consent, an ECG is performed in eligible patients. Children meet all the
criteria for inclusion and non-inclusion receive, at random, one of two treatments:
ondansetron (active) or placebo. The study does not alter the usual care of the child to the
emergency room. After passing emergency, patients will be followed in the study for 8 days,
through a phone call home to J3 and J7. The total duration of patient participation in the
study is 8 days, including 4 hours emergencies (usual transit time to emergencies).
Acute gastroenteritis is a common disease especially in children. With bronchiolitis and
influenza, she participated widely in weight of winter epidemics that causes problems every
year our health care system, particularly in the pediatric emergency and inpatient since
they are the second leading cause of hospitalization in children. The main symptoms of viral
acute gastroenteritis are diarrhea and vomiting which exposes children to the risk of
sometimes severe dehydration, the most common cause of hospitalization. There is no specific
treatment for these infections. At most, there is a vaccine against severe rotavirus
diarrhea (Rotarix ® and RotaTeq ®), but does not yet official recommendations to use in
France. The treatment of acute gastroenteritis virus is symptomatic and is generally based
on the use of oral rehydration solutions (ORS) whose administration is limited by the
frequent presence of vomiting. Until now, no treatment has demonstrated its effectiveness on
vomiting due to acute gastroenteritis virus in children. Conventional anti-emetics, widely
prescribed, are ineffective in practice, very few studies in this indication and encumbered
side effects. Several drugs have long been used in children to fight against severe vomiting
associated with the administration of anti-cancer chemotherapy, such as granisetron (Kytril
®) and ondansetron (Zofren ®). The mechanism of action of these molecules is well known.
They act both on the enteric nervous system by blocking serotonin receptors. Several
placebo-controlled trials suggest that ondansetron is effective in reducing the number of
vomiting in children emergency consultant for acute gastroenteritis. However, the method
used in these tests and the number of children enrolled has not yet demonstrated the
efficacy of ondansetron on the number of admissions, the number of emergency and return the
cost / benefit ratio of this treatment. In addition, several studies reported the occurrence
of watery stools more frequently in children treated with the placebo group.
Evidence that ondansetron is well tolerated and effective for reducing the severity of
vomiting during acute gastroenteritis pediatrics winter could support the use of this
treatment in routine pediatric emergencies.
This study is a clinical trial, multicenter, controlled versus placebo whose main objective
is to evaluate the efficacy of ondansetron to decrease the intensity of vomiting in children
with acute gastroenteritis during winter emergencies Upon arrival to the emergency room
after signing. Consent, an ECG is performed in eligible patients. Children meet all the
criteria for inclusion and non-inclusion receive, at random, one of two treatments:
ondansetron (active) or placebo. The study does not alter the usual care of the child to the
emergency room. After passing emergency, patients will be followed in the study for 8 days,
through a phone call home to J3 and J7. The total duration of patient participation in the
study is 8 days, including 4 hours emergencies (usual transit time to emergencies).
Outside the study drug administration, it will be in the framework of the research:
- An electrocardiogram inclusion
- A stool specimen
- A fill two questionnaires, one of which during the passage of emergency and the other
during two phone calls within 7 days after the departure of emergencies.
This will be done in addition to the balance necessary to support the patient.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Treatment
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