Study shows home care works for kids with stomach flu

Understanding the Impact of Anti-Vomiting Medication on Children in Emergency Care

Emergency departments (EDs) are often the first point of contact for children experiencing severe vomiting. While most children are eventually discharged home after receiving care, many face a recurrence of symptoms within a short time. This recurring issue has prompted medical professionals to explore more effective treatment strategies to ensure better recovery outcomes.

Dr. Stephen Freedman, a pediatric emergency medicine physician and professor at the Cumming School of Medicine, led a significant national study to evaluate the effectiveness of anti-vomiting medication in children who have been treated for acute intestinal infections. The study aimed to determine whether providing an anti-nausea drug like ondansetron could help reduce the likelihood of vomiting returning after discharge.

Gastroenteritis, which causes inflammation of the stomach and intestines, is a common condition among children. It leads to over two million emergency department visits annually in North America and results in thousands of hospitalizations. Despite its prevalence, there has been ongoing debate about the best approach to managing symptoms after a child leaves the hospital.

Freedman and his team conducted a double-blind randomized clinical trial across six pediatric hospitals in Canada. They enrolled over 1,000 children aged six months to 18 years and found that ondansetron, a well-tolerated and safe anti-nausea medication, can effectively prevent vomiting when administered at home. The study was published in The New England Journal of Medicine and revealed that children who received ondansetron were less likely to experience moderate-to-severe symptoms following their ED discharge.

In an earlier study, Freedman’s team discovered that ondansetron works well in stopping vomiting and reducing the need for intravenous fluids when given as a single dose in the ED. However, some children experienced a recurrence of symptoms at home. This new study shows that providing a small number of additional doses to be taken at home can benefit those with ongoing symptoms.

The research involved institutions within the Pediatric Emergency Research Canada (PERC) network. Dr. Terry P. Klassen, a co-founder of PERC and co-author of the study, emphasized the importance of collaboration in conducting clinical trials that provide evidence-based solutions for pediatric emergency care. He noted that the study highlights the value of investing in research and the effectiveness of Canadian researchers in addressing critical health issues.

The findings from this study have been incorporated into national recommendations for emergency department healthcare providers. These guidelines, published by Translating Emergency Knowledge for Kids (TREKK), aim to improve the care of children with gastroenteritis by ensuring appropriate use of ondansetron.

Looking ahead, Freedman plans to identify specific sub-groups of children who may benefit most from ondansetron. This will allow clinicians to tailor the administration of the medication to those patients for whom it will be most effective.

The study, titled “Multidose Ondansetron after Emergency Visits in Children with Gastroenteritis,” was published in The New England Journal of Medicine in 2025. It provides crucial evidence that children with frequent and recent vomiting due to an intestinal infection should be provided with two doses of ondansetron at the time of ED discharge.

This research represents a significant step forward in understanding how to manage gastroenteritis in children more effectively. By offering targeted treatment options, healthcare providers can help ensure that children recover more comfortably and with fewer complications.