title: Ondansetron in acute food protein-induced enterocolitis syndrome, a retrospective case-control study.
abstract: BACKGROUND
  Therapy for moderate to severe acute food protein-induced enterocolitis syndrome (FPIES) typically consists of intravenous fluids and corticosteroids (traditional therapy). Ondansetron has been suggested as an adjunctive treatment. We aimed to evaluate the efficacy of the parenteral (intravenous or intramuscular) ondansetron vs traditional therapy to resolve the symptoms of acute FPIES.
  
  
  METHODS
  Cases of FPIES who had a positive oral food challenge (OFC) were retrospectively examined at two major hospitals over a two-year period (Rome, Italy; and Sydney, Australia). The efficacy of therapy, based on the percentage of cases who stopped vomiting, was compared in cases who received parenteral ondansetron and in cases who received traditional therapy or no pharmacological therapy.
  
  
  RESULTS
  A total of 66 patients were included: 37 had parenteral ondansetron, 14 were treated with traditional therapy, and 15 did not receive any pharmacological therapy. Nineteen percentage of children treated with ondansetron continued vomiting after the administration of the therapy vs 93% of children who received traditional therapy (P < 0.05, relative risk = 0.2). Children who received ondansetron or no therapy were less likely to require an admission overnight compared with those who received traditional therapy (P < 0.05).
  
  
  CONCLUSIONS
  Parenteral ondansetron is significantly more effective than traditional therapy in resolving acute symptoms of FPIES. The relative risk = 0.2 greatly reduces the bias linked to the lack of randomization. These findings suggest an effective treatment for vomiting in positive FPIES OFCs and allow for more confidence in performing OFCs.
authors.affiliation: Department of Paediatrics, Allergy Unit, Agostino Gemelli Hospital, Sacred Heart Catholic University, Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Miceli Sopo
authors.affiliation: Department of Paediatrics, Allergy Unit, Agostino Gemelli Hospital, Sacred Heart Catholic University, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Bersani
authors.affiliation: Department of Paediatrics, Allergy Unit, Agostino Gemelli Hospital, Sacred Heart Catholic University, Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Monaco
authors.affiliation: Department of Paediatrics, Allergy Unit, Agostino Gemelli Hospital, Sacred Heart Catholic University, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Cerchiara
authors.affiliation: Department of Allergy and Immunology, Children's Hospital at Westmead, Sydney, NSW, Australia.
authors.forename: E
authors.initials: E
authors.lastname: Lee
authors.affiliation: Department of Allergy and Immunology, Children's Hospital at Westmead, Sydney, NSW, Australia.
authors.forename: D
authors.initials: D
authors.lastname: Campbell
authors.affiliation: Department of Allergy and Immunology, Children's Hospital at Westmead, Sydney, NSW, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Mehr
mesh_terms: D000485:Allergens / Q000276:immunology*; D018926:Anti-Allergic Agents / Q000494:pharmacology / Q000627:therapeutic use; D016022:Case-Control Studies; D002675:Child, Preschool; D004044:Dietary Proteins / Q000276:immunology*; D004760:Enterocolitis / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology*; D005260:Female; D005502:Food / Q000009:adverse effects*; D005512:Food Hypersensitivity / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology*; D006801:Humans; D007223:Infant; D008297:Male; D017294:Ondansetron / Q000494:pharmacology / Q000627:therapeutic use*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000485:Allergens; D018926:Anti-Allergic Agents; D004044:Dietary Proteins; D017294:Ondansetron
keywords: food allergy; food protein-induced enterocolitis syndrome; ondansetron; oral food challenge; steroids