title: Effectiveness of granisetron in controlling pediatric gastroenteritis-related vomiting after discharge from the ED.
abstract: OBJECTIVE
  The objective of the study is to determine the efficacy of oral granisetron (a long-acting 5-HT3 receptor antagonist) in stopping vomiting subsequent to discharge from emergency department (ED), in 6-month-old to 8-year-old patients with gastroenteritis-related vomiting and dehydration, who had failed an initial trial of oral rehydration (ORT).
  
  
  METHODS
  Eligible patients were offered ORT on a slowly advancing schedule. Patients who tolerated the initial ORT were discharged home. Patients who vomited were randomized to receive either 40 μg/kg of granisetron or placebo, and ORT was resumed. Patients who tolerated the postrandomization ORT were discharged home with another dose of the study drug. Parents were contacted by telephone every 24 hours until complete resolution of symptoms. The primary outcome was the proportion of patients with vomiting at 24 hours.
  
  
  RESULTS
  Of the 900 eligible patients, 537 (60%) tolerated the initial ORT and were discharged home. Of the patients who vomited during the initial ORT, 165 were included in the final study sample (placebo, n = 82; granisetron, n = 83). There was no statistically significant difference in the proportion of patients with vomiting at 24 hours (granisetron, n = 38; placebo, n = 45; odds ratio, 0.64; 95% confidence interval, 0.34-1.19; P = .16). A similar trend in the proportion of patients with vomiting was noted for the entire follow-up period (granisetron, n = 43; placebo, n = 47; odds ratio, 0.73; P = .33; 95% confidence interval, 0.39-1.36).
  
  
  CONCLUSIONS
  Granisetron was not effective in controlling gastroenteritis-related vomiting subsequent to discharge from ED. It did not change the expected course of the illness.
authors.affiliation: King Fahd Medical City, Emergency Medicine, Riyadh, Riyadh 11525, Saudi Arabia. Electronic address: kajista@yahoo.com.
authors.forename: Khajista
authors.initials: K
authors.lastname: Qazi
authors.affiliation: College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Hashim M
authors.initials: HM
authors.lastname: BinSalleeh
authors.affiliation: King Fahd Medical City, Riyadh, Saudi Arabia.
authors.forename: Ubaid H
authors.initials: UH
authors.lastname: Shah
authors.affiliation: King Fahd Medical City, Riyadh, Saudi Arabia.
authors.forename: Najwa
authors.initials: N
authors.lastname: AlGhamedi
authors.affiliation: American University of Beirut, Beirut, Lebanon.
authors.forename: Hani
authors.initials: H
authors.lastname: Tamim
authors.affiliation: King Fahd Medical City, Riyadh, Saudi Arabia.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Mubasher
authors.affiliation: College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Faris
authors.initials: F
authors.lastname: Alrasheed
authors.affiliation: College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Abdulrahman
authors.initials: A
authors.lastname: Alkanhal
authors.affiliation: King Fahd Medical City, Riyadh, Saudi Arabia.
authors.forename: Saleh A
authors.initials: SA
authors.lastname: AlTamimi
mesh_terms: D000932:Antiemetics / Q000627:therapeutic use*; D004311:Double-Blind Method; D004636:Emergency Service, Hospital; D005260:Female; D005440:Fluid Therapy / Q000379:methods; D005759:Gastroenteritis / Q000150:complications* / Q000188:drug therapy; D017829:Granisetron / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D008297:Male; D010351:Patient Discharge; D016896:Treatment Outcome; D014839:Vomiting / Q000188:drug therapy*
chemical_list: D000932:Antiemetics; D017829:Granisetron