Aisha Fnu, Bhagwani Kanwal, Ijaz Huda, Kandachia Krupali, Kumar Naresh, Faisal Sana, Jha Saswat, Khan Samiullah
Medicine, Medical College, Liaquat University of Medical and Health Sciences, Hyderabad, PAK.
Medicine, Chandka Medical College, Larkana, PAK.
Cureus. 2022 Aug 3;14(8):e27636. doi: 10.7759/cureus.27636. eCollection 2022 Aug.
Acute gastroenteritis is one of the common diseases of childhood. Dehydration is the most frequent consequence of acute gastroenteritis, and vomiting is the most distressing clinical manifestation. Various anti-emetic agents are used in practice to control vomiting. However, not all anti-emetic agents are safe and effective. This meta-analysis aims to compare the effectiveness of ondansetron and domperidone in the cessation of vomiting in children with acute gastroenteritis. The current meta-analysis was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search strategy was developed to identify prospective studies that compared the effectiveness of ondansetron and domperidone in the cessation of vomiting in children with acute gastroenteritis. The primary outcome was the number of children in whom there was a cessation of vomiting. The secondary outcomes included a number of children who required an additional dose of the assigned anti-emetic and the number of children who required intravenous rehydration therapy. Overall, seven randomized trials were included in the current meta-analysis. The pooled sample size of enrolled patients was 1,262, of which 639 patients were randomized to the ondansetron group and 623 were randomized to the domperidone group. In the ondansetron group, a higher number of children experienced cessation of vomiting (risk ratio [RR]: 1.22, 95% CI: 1.08-1.37, p-value=0.002), a lower proportion of children needed an additional dose of the assigned anti-emetic (RR=0.50, 95% CI: 0.33-0.77, p-value=0.002), and a lower number of children received intravenous rehydration (RR: 0.37, 95% CI: 0.16-0.83, p-value=0.02) as compared to domperidone group. Compared to domperidone, ondansetron was found to have better efficiency in aiming cessation of vomiting in children with gastroenteritis.
急性肠胃炎是儿童常见疾病之一。脱水是急性肠胃炎最常见的后果，而呕吐是最令人痛苦的临床表现。在实际应用中，人们使用各种止吐药来控制呕吐。然而，并非所有止吐药都是安全有效的。本荟萃分析旨在比较昂丹司琼和多潘立酮在治疗急性肠胃炎儿童呕吐方面的有效性。当前的荟萃分析是按照系统评价和荟萃分析的首选报告项目（PRISMA）指南进行的。制定了全面的检索策略，以识别比较昂丹司琼和多潘立酮在治疗急性肠胃炎儿童呕吐方面有效性的前瞻性研究。主要结局是呕吐停止的儿童数量。次要结局包括需要额外剂量指定止吐药的儿童数量以及需要静脉补液治疗的儿童数量。总体而言，当前的荟萃分析纳入了七项随机试验。纳入患者的合并样本量为1262例，其中639例患者被随机分配到昂丹司琼组，623例被随机分配到多潘立酮组。与多潘立酮组相比，昂丹司琼组有更多儿童呕吐停止（风险比[RR]：1.22，95%置信区间：1.08 - 1.37，p值 = 0.002），需要额外剂量指定止吐药的儿童比例更低（RR = 0.50，95%置信区间：0.33 - 0.77，p值 = 0.002），接受静脉补液的儿童数量更少（RR：0.37，95%置信区间：0.16 - 0.83，p值 = 0.02）。与多潘立酮相比，发现昂丹司琼在治疗肠胃炎儿童呕吐停止方面具有更高的效率。
