In this study, we determine the clinical impact of 1 dose of oral
ondansetron for children with
vomiting and evaluate the economic consequences of its use. The strategies compared were administering oral
ondansetron in addition to
oral rehydration therapy (group A) versus
oral rehydration solution alone (group B) in children attended to for
vomiting in a pediatric emergency department. The study population was 1871 children between 0 and 14 years of age treated for
vomiting during a 2-year period (2009-2010). Outcome measures were need for intravenous
rehydration,
length of stay in the emergency department, return visits, and hospitalization. Estimates of the costs in the emergency department and hospitalization were derived from administrative databases. During the study period, 580 (31%) of 1871 patients received
oral rehydration therapy. Oral
ondansetron before
oral rehydration solution was used in 109 (18.8%) of 580 patients. An equal number of patients not receiving
ondansetron were randomized and analyzed for comparison (group B). Patients of group A had a significantly decreased risk of hospitalization (relative risk, 0.22; 95% confidence interval, 0.08-0.63) and intravenous
rehydration (relative risk, 0.31; 95% confidence interval, 0.14-0.63), but there were no differences in the
length of stay or return visits to the emergency department. There were no differences in the medical costs between both groups in the emergency department (US $22,078 vs US $21,987, respectively). The hospitalization cost was US $9600 for group A and US $25,079 for group B, providing a 73.7% saving. In conclusion, the administration of oral
ondansetron to children with
vomiting in the emergency department is clinically effective and results in significant economic savings.