title: Ondansetron use in the pediatric emergency room for diagnoses other than acute gastroenteritis.
abstract: BACKGROUND
  Ondansetron is widely used in the pediatric emergency department (PED) for vomiting and acute gastroenteritis (GE). Little is known about the spectrum of its use in diagnoses other than acute GE.
  
  
  OBJECTIVE
  The objective of this study was to evaluate the spectrum of diagnoses for which ondansetron is used in the PED.
  
  
  METHODS
  Medical records from 2 tertiary care PEDs from January 2006 to December 2008 were retrospectively reviewed. Patients 3 months to 18 years of age given ondansetron in the PED were identified. Patients without a primary discharge diagnosis (based on International Classification of Diseases, Ninth Revision code) of vomiting or GE were defined as non-GE. Patient age, initial triage level (1 = lowest acuity, 5 = highest), route of administration (enteral vs parenteral), primary diagnosis, disposition, and prescription for ondansetron at discharge were recorded; GE and non-GE patients were compared based on age and triage acuity.
  
  
  RESULTS
  There were 32,971 patients who received ondansetron in the PED; 12,620 (38%) were non-GE patients. Non-GE patients were older (8.3 vs 4.3 years, P < 0.001) and of higher average initial triage level (2.95 vs 2.33, P < 0.001) compared with GE patients. Within non-GE patients, 79% received ondansetron enterally, 71% were discharged, and 37% of those discharged received an ondansetron prescription. The most common primary diagnoses for non-GE discharged patients were fever (15%), abdominal pain/tenderness (13%), head injury/concussion (7%), pharyngitis (6%), viral infection (6%), migraine variants (5%), and otitis media (5%). The most common diagnoses of patients admitted were appendicitis (11%), asthma (6%), pneumonia (4%), and diabetes (4%).
  
  
  CONCLUSIONS
  Although ondansetron is a widely accepted treatment for GE in children, this study identifies a broader spectrum of primary diagnoses for which ondansetron is being used.
authors.affiliation: Pediatric Emergency Medicine, Emory University, Children's Healthcare of Atlanta, Atlanta, GA 30307, USA. jesse.sturm@gmail.com
authors.forename: Jesse J
authors.initials: JJ
authors.lastname: Sturm
authors.forename: Amanda
authors.initials: A
authors.lastname: Pierzchala
authors.forename: Harold K
authors.initials: HK
authors.lastname: Simon
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Hirsh
mesh_terms: D000293:Adolescent; D000932:Antiemetics / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D017294:Ondansetron / Q000627:therapeutic use*; D010372:Pediatrics / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014839:Vomiting / Q000188:drug therapy* / Q000209:etiology
chemical_list: D000932:Antiemetics; D017294:Ondansetron