Although guidelines endorse oral rehydration therapy, intravenous fluids are commonly administered to children with acute gastroenteritis in high-income countries.

The present study identified factors associated with intravenous fluid administration and hospitalization in children with acute gastroenteritis.

It was a planned secondary analysis of the Pediatric Emergency Research Canada (PERC) and Pediatric Emergency Care Applied Research Network (PECARN) probiotic trials. It included children aged 3 to 48 months with three or more watery stools in 24 hours. 

The study looked for intravenous fluid administration and hospitalization.

The study observed-

• Of the 1846 enrolled children, 28.9% received oral ondansetron, 13.0% received intravenous rehydration, and 3.6% received hospitalization.
• Independent association between intravenous rehydration and: higher Clinical Dehydration Scale score (mild to moderate vs. none, and severe vs. none); country (US vs. Canada); prior health care visit with intravenous fluids; and frequency of vomiting (per 5 episodes).
• Independent association with hospitalization and: higher Clinical Dehydration Scale score (mild to moderate vs. none, and severe vs. none) and country (US vs. Canada).
• Association between Oral ondansetron and reduced odds of intravenous rehydration and hospitalization.

This study associated intravenous rehydration and hospitalization with clinical evidence of dehydration and lack of an oral ondansetron-supported oral rehydration period. Strategies focusing on oral ondansetron administration followed by oral rehydration therapy in children with dehydration may decrease intravenous rehydration and hospitalization dependency.

JAMA Netw Open. 2021 Apr 1;4(4):e216433. doi: 10.1001/jamanetworkopen.2021.6433. Erratum in: JAMA Netw Open. 2021 Jun 1;4(6):e2116800. PMID: 33871616; PMCID: PMC8056281.