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Gastroenteritis is a common disease, usually of viral origin that inflames both the stomach and small intestine. It is characterized by fever, diarrhea and vomiting.

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Bottom Line Recommendations English (1) French (1) All (2)

Bottom Line Recommendations: Gastroenteritis

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Freedman S, & TREKK Network

Bottom line recommendations for the treatment and management of pediatric gastroenteritis

Recommendations de Base: Gastro-entrite

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Freedman S, & TREKK Network

Bottom line recommendations for the treatment and management of pediatric gastroenteritis. Posted April 2019, v 3.0.

Bottom Line Recommendations: Gastroenteritis

Download

Freedman S, & TREKK Network

Bottom line recommendations for the treatment and management of pediatric gastroenteritis

Recommendations de Base: Gastro-entrite

Download

Freedman S, & TREKK Network

Bottom line recommendations for the treatment and management of pediatric gastroenteritis. Posted April 2019, v 3.0.

Clinical guidelines English (8) French All (8)

Clinical Practice Guideline: Gastroenteritis

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The Royal Children's Hospital Melbourne

These guidelines contain information about assessment, diagnosis and management of pediatric gastroenteritis.

Clinical Practice Guideline: European Society for Pediatric Gastroenterology, Hepatology, and Nutrition/European Society for Pediatric Infectious Diseases evidence-based guidelines for the management of acute gastroenteritis in children in Europe: up

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Guarino A, Ashkenazi S, Gendrel D, Lo Vecchio A, Shamir R, Szajewska H, Europ...

These guidelines update and extend evidence-based indications for the management of children with acute gastroenteritis in Europe.

Clinical Practice Guideline: Use of probiotics for management of acute gastroenteritis: a position paper by the ESPGHAN Working Group for Probiotics and Prebiotics

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Szajewska H, Guarino A, Hojsak I, Indrio F, Kolacek S, Shamir R, Vandenplas Y...

This document provides recommendations for the use of probiotics for the treatment of acute gastroenteritis in previously healthy infants and children based on a systematic review of previously completed systematic reviews and of randomized controlled trials (RCTs) published subsequently to these reviews.

Clinical Pathway: Alberta Health Services Acute Childhood Vomiting & Diarrhea Pathway

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Alberta Health Services

This pathway, developed for Alberta Health Services, is intended for children between 3 months and 10 years of age with vomiting and/or diarrhea with or without accompanying nausea, fever or abdominal pain.

Clinical Practice Guideline: Prevention and management of acute gastroenteritis (AGE) in children aged 2 months to 18 years

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Cincinnati Children's Hospital Medical Center,

Developed by Cincinnati Children's Hospital Medical Center. Published: December 2011.

Clinical Practice Guideline: Emergency department use of oral ondansetron for acute gastroenteritis-related vomiting in infants and children

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Cheng A

This article examines evidence for the use of oral ondansetron for acute gastroenteritis-related vomiting in infants and children, and provides a recommendation for treatment based on the evidence-based review.

Clinical Practice Guideline: Diarrhoea and vomiting caused by gastroenteritis in under 5s: diagnosis and management

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National Institute for Health and Care Excellence

This guideline covers diagnosing, managing and referring infants and young children younger than 5 years who present with acute diarrhoea (lasting up to 14 days) with or without vomiting.

Clinical Practice Guideline: Managing acute gastroenteritis among children: oral rehydration, maintenance, and nutritional therapy

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King CK, Glass R, Bresee JS, Duggan C, Centers for Disease Control and Preven...

This report reviews the historical background and scientific basis of oral rehydration therapy and provides a framework for assessing and treating infants and children who have acute diarrhea.

Clinical Practice Guideline: Gastroenteritis

Visit

The Royal Children's Hospital Melbourne

These guidelines contain information about assessment, diagnosis and management of pediatric gastroenteritis.

Clinical Practice Guideline: European Society for Pediatric Gastroenterology, Hepatology, and Nutrition/European Society for Pediatric Infectious Diseases evidence-based guidelines for the management of acute gastroenteritis in children in Europe: up

Visit

Guarino A, Ashkenazi S, Gendrel D, Lo Vecchio A, Shamir R, Szajewska H, Europ...

These guidelines update and extend evidence-based indications for the management of children with acute gastroenteritis in Europe.

Clinical Practice Guideline: Use of probiotics for management of acute gastroenteritis: a position paper by the ESPGHAN Working Group for Probiotics and Prebiotics

Visit

Szajewska H, Guarino A, Hojsak I, Indrio F, Kolacek S, Shamir R, Vandenplas Y...

This document provides recommendations for the use of probiotics for the treatment of acute gastroenteritis in previously healthy infants and children based on a systematic review of previously completed systematic reviews and of randomized controlled trials (RCTs) published subsequently to these reviews.

Clinical Pathway: Alberta Health Services Acute Childhood Vomiting & Diarrhea Pathway

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Alberta Health Services

This pathway, developed for Alberta Health Services, is intended for children between 3 months and 10 years of age with vomiting and/or diarrhea with or without accompanying nausea, fever or abdominal pain.

Clinical Practice Guideline: Prevention and management of acute gastroenteritis (AGE) in children aged 2 months to 18 years

Visit

Cincinnati Children's Hospital Medical Center,

Developed by Cincinnati Children's Hospital Medical Center. Published: December 2011.

Clinical Practice Guideline: Emergency department use of oral ondansetron for acute gastroenteritis-related vomiting in infants and children

Visit

Cheng A

This article examines evidence for the use of oral ondansetron for acute gastroenteritis-related vomiting in infants and children, and provides a recommendation for treatment based on the evidence-based review.

Clinical Practice Guideline: Diarrhoea and vomiting caused by gastroenteritis in under 5s: diagnosis and management

Visit

National Institute for Health and Care Excellence

This guideline covers diagnosing, managing and referring infants and young children younger than 5 years who present with acute diarrhoea (lasting up to 14 days) with or without vomiting.

Clinical Practice Guideline: Managing acute gastroenteritis among children: oral rehydration, maintenance, and nutritional therapy

Visit

King CK, Glass R, Bresee JS, Duggan C, Centers for Disease Control and Preven...

This report reviews the historical background and scientific basis of oral rehydration therapy and provides a framework for assessing and treating infants and children who have acute diarrhea.

Summaries of systematic reviews English (5) French All (5)

Cochrane Summary: The use of probiotics to prevent Clostridium difficile diarrhea associated with antibiotic use

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Goldenberg JZ, Yap C, Lytvyn L, Lo CK, Beardsley J, Mertz D, Johnston BC

Summarizes research to determine if probiotics prevent Clostridium difficile-associated diarrhea in adults and children receiving antibiotic therapy, and whether probiotics cause any harms.

Evidence Summary: Gastroenteritis

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Alberta Research Centre for Health Evidence (ARCHE)

The purpose of this document is to describe the effectiveness of three treatment options for pediatric gastroenteritis, based on a 2013 overview of reviews by Freedman SB et al.

Cochrane Overview: Treatment of acute gastroenteritis in children: an overview of systematic reviews of interventions commonly used in developed countries

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Freedman SB, Ali S, Oleszczuk M, Gouin S, Hartling L

The purpose of this overview is to critically evaluate the evidence currently available in the Cochrane Database of Systematic Reviews regarding the efficacy and safety of commonly considered treatment options in children with acute gastroenteritis.

Cochrane Summary: Anti-sickness medication for vomiting in acute stomach upsets in children

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Fedorowicz Z, Jagannath VA, Carter B

Vomiting caused byacutegastroenteritis is very common in children and adolescents. Treatment of vomiting in children withacutegastroenteritis can be problematic and there is lack of agreement among clinicians on the indications for the use of antiemetics. There have also been concerns expressed about apparently unacceptable levels of side effects with some of the older generation of antiemetics. The small number of included trials provided evidence which appeared to favour the use of antiemetics overplaceboto reduce the number of episodes of vomiting due to gastroenteritis in children. A singleoraldose of ondansetron given to children with mild to moderate dehydration cancontrolvomiting, avoid hospitalization andintravenousfluid administration which would otherwise be needed. There were no major side effects other than a few reports of increased frequency of diarrhea.

Cochrane Summary: Children with dehydration due to gastroenteritis need to be rehydrated, and this review did not show any important differences between giving fluids orally or intravenously

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Hartling L, Bellemare S, Wiebe N, Russell KF, Klassen TP, Craig WR

Dehydration is when body water content is reduced causing dry skin, headaches, sunken eyes, dizziness, confusion, and sometimes death. Children with dehydration due to gastroenteritis need rehydrating either by liquids given by mouth or a tube through the nose, or intravenously. Thereviewof 17 trials (some funded by drug companies) found that the trials were not of high quality; however the evidence suggested that there are no clinically important differences between giving fluids orally or intravenously. For every 25 children treated with fluids given orally, one child would fail and requireintravenousrehydration. Further, the results for low osmolarity solutions, the currently recommended treatment by the World Health Organization, showed a lower failure rate fororalrehydration that was not significantly different from that ofintravenousrehydration. Oral rehydration should be the first line of treatment in children with mild to moderate dehydration withintravenoustherapybeing used if theoralroute fails. The evidence showed that there may be a higherriskof paralytic ileus withoralrehydration whileintravenoustherapycarries theriskofphlebitis(ie inflammation of the veins).

Cochrane Summary: The use of probiotics to prevent Clostridium difficile diarrhea associated with antibiotic use

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Goldenberg JZ, Yap C, Lytvyn L, Lo CK, Beardsley J, Mertz D, Johnston BC

Summarizes research to determine if probiotics prevent Clostridium difficile-associated diarrhea in adults and children receiving antibiotic therapy, and whether probiotics cause any harms.

Evidence Summary: Gastroenteritis

Download

Alberta Research Centre for Health Evidence (ARCHE)

The purpose of this document is to describe the effectiveness of three treatment options for pediatric gastroenteritis, based on a 2013 overview of reviews by Freedman SB et al.

Cochrane Overview: Treatment of acute gastroenteritis in children: an overview of systematic reviews of interventions commonly used in developed countries

Visit

Freedman SB, Ali S, Oleszczuk M, Gouin S, Hartling L

The purpose of this overview is to critically evaluate the evidence currently available in the Cochrane Database of Systematic Reviews regarding the efficacy and safety of commonly considered treatment options in children with acute gastroenteritis.

Cochrane Summary: Anti-sickness medication for vomiting in acute stomach upsets in children

Visit

Fedorowicz Z, Jagannath VA, Carter B

Vomiting caused byacutegastroenteritis is very common in children and adolescents. Treatment of vomiting in children withacutegastroenteritis can be problematic and there is lack of agreement among clinicians on the indications for the use of antiemetics. There have also been concerns expressed about apparently unacceptable levels of side effects with some of the older generation of antiemetics. The small number of included trials provided evidence which appeared to favour the use of antiemetics overplaceboto reduce the number of episodes of vomiting due to gastroenteritis in children. A singleoraldose of ondansetron given to children with mild to moderate dehydration cancontrolvomiting, avoid hospitalization andintravenousfluid administration which would otherwise be needed. There were no major side effects other than a few reports of increased frequency of diarrhea.

Cochrane Summary: Children with dehydration due to gastroenteritis need to be rehydrated, and this review did not show any important differences between giving fluids orally or intravenously

Visit

Hartling L, Bellemare S, Wiebe N, Russell KF, Klassen TP, Craig WR

Dehydration is when body water content is reduced causing dry skin, headaches, sunken eyes, dizziness, confusion, and sometimes death. Children with dehydration due to gastroenteritis need rehydrating either by liquids given by mouth or a tube through the nose, or intravenously. Thereviewof 17 trials (some funded by drug companies) found that the trials were not of high quality; however the evidence suggested that there are no clinically important differences between giving fluids orally or intravenously. For every 25 children treated with fluids given orally, one child would fail and requireintravenousrehydration. Further, the results for low osmolarity solutions, the currently recommended treatment by the World Health Organization, showed a lower failure rate fororalrehydration that was not significantly different from that ofintravenousrehydration. Oral rehydration should be the first line of treatment in children with mild to moderate dehydration withintravenoustherapybeing used if theoralroute fails. The evidence showed that there may be a higherriskof paralytic ileus withoralrehydration whileintravenoustherapycarries theriskofphlebitis(ie inflammation of the veins).

Systematic reviews English (13) French All (13)

Systematic Review: Diagnostic accuracy of three clinical dehydration scales: a systematic review

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Falszewska A, Szajewska H, Dziechciarz P

Objective: To systematically assess the diagnostic accuracy of the Clinical Dehydration Scale, the WHO Scale and the Gorelick Scale in identifying dehydration in children with acute gastroenteritis.

Systematic Review: Comparative effectiveness and safety of interventions for acute diarrhea and gastroenteritis in children: A systematic review and network meta-analysis

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Florez ID, Veroniki AA, Al Khalifah R, Yepes-Nuez JJ, Sierra JM, Vernooij RWM...

Objective: To determine the comparative effectiveness and safety of the pharmacological and nutritional interventions for reducing the duration of acute diarrhea and gastroenteritis in children.

Systematic Review: Rapid intravenous rehydration of children with acute gastroenteritis and dehydration: a systematic review and meta-analysis

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Iro MA, Sell T, Brown N, Maitland K

Objective: To compare rapid and slower intravenous rehydration rates for children with acute gastroenteritis.

Review: Antimicrobial treatment of diarrhea/acute gastroenteritis in children

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Cohen R, Raymond J, Gendrel D

The antimicrobial treatments proposed in this guide follow the latest guidelines of the European Society of Pediatric Infectious Diseases and the European Society of Pediatric Gastroenterology and Nutrition. Azithromycin is the preferred antibiotic for infections due to Shigella and Campylobacter. Ceftriaxone and ciprofloxacin are recommended for salmonellosis when antibiotic treatment is indicated.

Cochrane Systematic Review: Probiotics for the prevention of Clostridium difficile-associated diarrhea in adults and children

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Goldenberg JZ, Yap C, Lytvyn L, Lo CK, Beardsley J, Mertz D, Johnston BC

Objectives: To assess the efficacy and safety of probiotics for preventing Clostridium difficile-associated diarrhea in adults and children

Systematic Review: Iatrogenic Dysnatremias in Children with Acute Gastroenteritis in High-Income Countries: A Systematic Review

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Grisaru S, Xie J, Samuel S, Freedman SB

Objectives: To evaluate the association between acquired dysnatremias and intravenous rehydration in children with acute gastroenteritis.

Systematic Review: Associations Between Hydration Status, Intravenous Fluid Administration, and Outcomes of Patients Infected With Shiga Toxin-Producing Escherichia coli: A Systematic Review and Meta-analysis

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Grisaru S, Xie J, Samuel S, Hartling L, Tarr PI, Schnadower D, Freedman SB; A...

Objectives: To determine the relationship between hydration status, the development and severity of hemolytic uremic syndrome, and adverse outcomes in Shiga toxin-producing Escherichia coli-infected individuals.

Systematic Review: Shiga Toxin-Producing Escherichia coli Infection, Antibiotics, and Risk of Developing Hemolytic Uremic Syndrome: A Meta-analysis

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Freedman SB, Xie J, Neufeld MS, Hamilton WL, Hartling L, Tarr PI; Alberta Pro...

This review assessed if antibiotic administration to individuals with Shiga toxin-producing Escherichia coli infection is associated with development of hemolytic uremic syndrome.

Systematic Review: Gastroenteritis Therapies in Developed Countries: Systematic Review and Meta-Analysis

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Freedman SB, Pasichnyk D, Black KJ, Fitzpatrick E, Gouin S, Milne A, Hartling...

This systematic review evaluates oral rehydration therapy (ORT), antiemetics, probiotics or intravenous fluids for children with gastroenteritis.

Review: Ondansetron and probiotics in the management of pediatric acute gastroenteritis in developed countries

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Schnadower D, Finkelstein Y, Freedman SB

The purpose of this review is to present the latest evidence regarding the use of adjunctive therapies, ondansetron and probiotics, in children with acute gastroenteritis.

Systematic Review: Diagnosing clinically significant dehydration in children with acute gastroenteritis using noninvasive methods: a meta-analysis

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Freedman SB, Vandermeer B, Milne A, Hartling L; Pediatric Emergency Research ...

Objective: To determine the most accurate, noninvasive method of assessing dehydration.

Cochrane Systematic Review: Antiemetics for reducing vomiting related to acute gastroenteritis in children and adolescents

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Fedorowicz Z, Jagannath VA, Carter B

This systematic review assesses the safety and effectiveness of antiemetics on gastroenteritis induced vomiting in children and adolescents.

Cochrane Systematic Review: Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children

Visit

Hartling L, Bellemare S, Wiebe N, Russell K, Klassen TP, Craig W

This systematic review compares oral with intravenous therapy for treating dehydration due to acute gastroenteritis in children.

Systematic Review: Diagnostic accuracy of three clinical dehydration scales: a systematic review

Visit

Falszewska A, Szajewska H, Dziechciarz P

Objective: To systematically assess the diagnostic accuracy of the Clinical Dehydration Scale, the WHO Scale and the Gorelick Scale in identifying dehydration in children with acute gastroenteritis.

Systematic Review: Comparative effectiveness and safety of interventions for acute diarrhea and gastroenteritis in children: A systematic review and network meta-analysis

Visit

Florez ID, Veroniki AA, Al Khalifah R, Yepes-Nuez JJ, Sierra JM, Vernooij RWM...

Objective: To determine the comparative effectiveness and safety of the pharmacological and nutritional interventions for reducing the duration of acute diarrhea and gastroenteritis in children.

Systematic Review: Rapid intravenous rehydration of children with acute gastroenteritis and dehydration: a systematic review and meta-analysis

Visit

Iro MA, Sell T, Brown N, Maitland K

Objective: To compare rapid and slower intravenous rehydration rates for children with acute gastroenteritis.

Review: Antimicrobial treatment of diarrhea/acute gastroenteritis in children

Visit

Cohen R, Raymond J, Gendrel D

The antimicrobial treatments proposed in this guide follow the latest guidelines of the European Society of Pediatric Infectious Diseases and the European Society of Pediatric Gastroenterology and Nutrition. Azithromycin is the preferred antibiotic for infections due to Shigella and Campylobacter. Ceftriaxone and ciprofloxacin are recommended for salmonellosis when antibiotic treatment is indicated.

Cochrane Systematic Review: Probiotics for the prevention of Clostridium difficile-associated diarrhea in adults and children

Visit

Goldenberg JZ, Yap C, Lytvyn L, Lo CK, Beardsley J, Mertz D, Johnston BC

Objectives: To assess the efficacy and safety of probiotics for preventing Clostridium difficile-associated diarrhea in adults and children

Systematic Review: Iatrogenic Dysnatremias in Children with Acute Gastroenteritis in High-Income Countries: A Systematic Review

Visit

Grisaru S, Xie J, Samuel S, Freedman SB

Objectives: To evaluate the association between acquired dysnatremias and intravenous rehydration in children with acute gastroenteritis.

Systematic Review: Associations Between Hydration Status, Intravenous Fluid Administration, and Outcomes of Patients Infected With Shiga Toxin-Producing Escherichia coli: A Systematic Review and Meta-analysis

Visit

Grisaru S, Xie J, Samuel S, Hartling L, Tarr PI, Schnadower D, Freedman SB; A...

Objectives: To determine the relationship between hydration status, the development and severity of hemolytic uremic syndrome, and adverse outcomes in Shiga toxin-producing Escherichia coli-infected individuals.

Systematic Review: Shiga Toxin-Producing Escherichia coli Infection, Antibiotics, and Risk of Developing Hemolytic Uremic Syndrome: A Meta-analysis

Visit

Freedman SB, Xie J, Neufeld MS, Hamilton WL, Hartling L, Tarr PI; Alberta Pro...

This review assessed if antibiotic administration to individuals with Shiga toxin-producing Escherichia coli infection is associated with development of hemolytic uremic syndrome.

Systematic Review: Gastroenteritis Therapies in Developed Countries: Systematic Review and Meta-Analysis

Visit

Freedman SB, Pasichnyk D, Black KJ, Fitzpatrick E, Gouin S, Milne A, Hartling...

This systematic review evaluates oral rehydration therapy (ORT), antiemetics, probiotics or intravenous fluids for children with gastroenteritis.

Review: Ondansetron and probiotics in the management of pediatric acute gastroenteritis in developed countries

Visit

Schnadower D, Finkelstein Y, Freedman SB

The purpose of this review is to present the latest evidence regarding the use of adjunctive therapies, ondansetron and probiotics, in children with acute gastroenteritis.

Systematic Review: Diagnosing clinically significant dehydration in children with acute gastroenteritis using noninvasive methods: a meta-analysis

Visit

Freedman SB, Vandermeer B, Milne A, Hartling L; Pediatric Emergency Research ...

Objective: To determine the most accurate, noninvasive method of assessing dehydration.

Cochrane Systematic Review: Antiemetics for reducing vomiting related to acute gastroenteritis in children and adolescents

Visit

Fedorowicz Z, Jagannath VA, Carter B

This systematic review assesses the safety and effectiveness of antiemetics on gastroenteritis induced vomiting in children and adolescents.

Cochrane Systematic Review: Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children

Visit

Hartling L, Bellemare S, Wiebe N, Russell K, Klassen TP, Craig W

This systematic review compares oral with intravenous therapy for treating dehydration due to acute gastroenteritis in children.

Key studies English (22) French All (22)

Key Study: Assessing Dehydration Employing End-Tidal Carbon Dioxide in Children With Vomiting and Diarrhea

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Freedman SB, Johnson DW, Nettel-Aguirre A, Mikrogianakis A, Williamson-Urquha...

This study evaluated whether end-tidal carbon dioxide predicts weight change in children with vomiting and/or diarrhea.

Key Study: Oral Ondansetron Administration to Nondehydrated Children With Diarrhea and Associated Vomiting in Emergency Departments in Pakistan: A Randomized Controlled Trial

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Freedman SB, Soofi SB, Willan AR, Williamson-Urquhart S, Ali N, Xie J, Dawoud...

Objective: To determine whether single-dose oral ondansetron administration to children with vomiting as a result of acute gastroenteritis without dehydration reduces administration of intravenous fluid rehydration.

Key Study: Multicenter Trial of a Combination Probiotic for Children with Gastroenteritis

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Freedman SB, Williamson-Urquhart S, Farion KJ, Gouin S, Willan AR, Poonai N, ...

Objective: To determine whether the use of probiotics improves outcomes in children with gastroenteritis.

Key Study: Efficacy of an Oral Rehydration Solution Enriched with Lactobacillus reuteri DSM 17938 and Zinc in the Management of Acute Diarrhoea in Infants: A Randomized, Double-Blind, Placebo-Controlled Trial

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Maragkoudaki M, Chouliaras G, Moutafi A, Thomas A, Orfanakou A, Papadopoulou A

Objective: to assess the efficacy of an oral rehydration solution enriched with Lactobacillus reuteri DSM 17938 and zinc in well-nourished, non-hospitalized infants with acute diarrhoea.

Key Study: Lactobacillus rhamnosus GG versus Placebo for Acute Gastroenteritis in Children

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Schnadower D, Tarr PI, Casper TC, Gorelick MH, Dean JM, O'Connell KJ, Mahajan...

This study evaluated outcomes for children with acute gastroenteritis who received Lactobacillus rhamnosus GG versus placebo.

Key Study: Performance of Stool Testing Recommendations for Acute Gastroenteritis when Used to Identify Children with Nine Potential Bacterial Enteropathogens

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Tarr GAM, Chui L, Lee BE, Pang XL, Ali S, Nettel-Aguirre A, Vanderkooi OG, Be...

This study evaluated six leading gastroenteritis guidelines for stool testing recommendations.

Key Study: Identification of Enteric Viruses in Oral Swabs from Children with Acute Gastroenteritis

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Zhuo R, Parsons BD, Lee BE, Drews SJ, Chui L, Louie M, Crago B, Freedman SB, ...

This study evaluated if oral swabs are a suitable alternative specimen to stools for identifying enteric viruses from children with acute gastroenteritis.

Key Study: Province-Wide Review of Pediatric Shiga Toxin-Producing Escherichia coli Case Management

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Freedman SB, Eltorki M, Chui L, Xie J, Feng S, MacDonald J, Dixon A, Ali S, L...

Objective: To identify the gaps in the care of children infected with Shiga toxin-producing Escherichia coli, this study sought to quantitate care received and management timelines.

Key Study: Enteropathogen detection in children with diarrhoea, or vomiting, or both, comparing rectal flocked swabs with stool specimens: an outpatient cohort study

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Freedman SB, Xie J, Nettel-Aguirre A, Lee B, Chui L, Pang XL, Zhuo R, Parsons...

Objective: to compare the enteropathogen yields of rectal swabs and stool specimens in children with diarrhoea or vomiting, or both.

Key Study: Implementation of clinical decision support in young children with acute gastroenteritis: a randomized controlled trial at the emergency department

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Geurts D, de Vos-Kerkhof E, Polinder S, Steyerberg E, van der Lei J, Moll H, ...

Objectives: To evaluate feasibility of a nurse-guided clinical decision support system for rehydration treatment in children with AGE, and the impact on diagnostics, treatment, and costs compared with usual care by attending physician.

Key Study: High genetic variability of norovirus leads to diagnostic test challenges

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Zhuo R, Cho J, Qiu Y, Parsons BD, Lee BE, Chui L, Freedman SB, Pang X; Albert...

Objectives: To characterize the cases of discordant norovirus genogroup II (NoV GII) results between Gastrointestinal Pathogen Panel (GPP) and Gastroenteritis Virus Panel (GVP), and determine the sensitivity of the two assays for specific NoV GII genotypes.

Key Study: A randomized trial of Plasma-Lyte A and 0.9 % sodium chloride in acute pediatric gastroenteritis

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Allen CH, Goldman RD, Bhatt S, Simon HK, Gorelick MH, Spandorfer PR, Spiro DM...

Objective: To compare the efficacy and safety of Plasma-Lyte A (PLA) versus 0.9 % sodium chloride (NaCl) intravenous (IV) fluid replacement in children with moderate to severe dehydration secondary to acute gastroenteritis.

Key Study: Evaluating the Impact of Clinical Decision Tools in Pediatric Acute Gastroenteritis: A Population-based Cohort Study

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Bahm A, Freedman SB, Guan J, Guttmann A

This study sought to determine if the following tools - 1) pathways/order sets, 2) medical directives for oral rehydration therapy (ORT) or ondansetron, and 3) printed discharge instructions - are associated with acute gastroenteritis admission and emergency department revisits.

Key Study: Effect of Dilute Apple Juice and Preferred Fluids vs Electrolyte Maintenance Solution on Treatment Failure Among Children With Mild Gastroenteritis: A Randomized Clinical Trial

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Freedman SB, Willan AR, Boutis K, Schuh S

Objective: To determine if oral hydration with dilute apple juice/preferred fluids is noninferior to electrolyte maintenance solution in children with mild gastroenteritis.

Key Study: Oral Ondansetron versus Domperidone for Acute Gastroenteritis in Pediatric Emergency Departments: Multicenter Double Blind Randomized Controlled Trial

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Marchetti F, Bonati M, Maestro A, Zanon D, Rovere F, Arrighini A, Barbi E, Be...

Objective: To evaluate whether a single oral dose of ondansetron vs domperidone or placebo improves outcomes in children with gastroenteritis.

Key Study: Should all acutely ill children in primary care be tested with point-of-care CRP: a cluster randomised trial

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Verbakel JY, Lemiengre MB, De Burghgraeve T, De Sutter A, Aertgeerts B, Shink...

Objective: To determine whether C-reactive protein (CRP) testing should be offered to all acutely ill children in primary care or restricted to those identified as at risk on clinical assessment.

Key Study: Cost-effectiveness of point-of-care testing for dehydration in the pediatric ED

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Whitney RE, Santucci K, Hsiao A, Chen L

Objective: To examine the cost-effectiveness of using point-of-care electrolyte testing vs traditional serum chemistry testing in the pediatric emergency department for children with acute gastroenteritis.

Key Study: Emergency Department Treatment of Children With Diarrhea Who Attend Day Care: A Randomized Multidose Trial of a Lactobacillus helveticus and Lactobacillus rhamnosus Combination Probiotic

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Freedman SB, Sherman PM, Willan A, Johnson D, Gouin S, Schuh S; Pediatric Eme...

This study evaluated the rates of day care absenteeism of children with gastroenteritis treated with probiotics.

Key Study: Impact of increasing ondansetron use on clinical outcomes in children with gastroenteritis

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Freedman SB, Hall M, Shah SS, Kharbanda AB, Aronson PL, Florin TA, Mistry RD,...

The objective of this retrospective study is to determine whether increasing emergency department ondansetron use results in a reduction in intravenous rehydration rates in children with gastroenteritis.

Key Study: Emergency department revisits in children with gastroenteritis

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Freedman SB, Thull-Freedman JD, Rumantir M, Atenafu EG, Stephens D

The aim of the study is to determine whether intravenous fluid administration to children with gastroenteritis is independently associated with a reduction in unscheduled emergency department (ED) revisits within 7 days.

Key Study: Oral ondansetron for gastroenteritis in a pediatric emergency department

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Freedman SB, Adler M, Seshadri R, Powell EC

The aim of this trial is to determine whether a single dose of ondansetron would improve outcomes in children with gastroenteritis.

Key Study: Oral versus intravenous rehydration of moderately dehydrated children: a randomized, controlled trial

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Spandorfer PR, Alessandrini EA, Joffe MD, Localio R, Shaw KN

The objective of this trial is to test the hypothesis that the failure rate of oral rehydration therapy would be not be >5% greater than the failure rate of intravenous fluid therapy for moderately dehydrated children.

Key Study: Assessing Dehydration Employing End-Tidal Carbon Dioxide in Children With Vomiting and Diarrhea

Visit

Freedman SB, Johnson DW, Nettel-Aguirre A, Mikrogianakis A, Williamson-Urquha...

This study evaluated whether end-tidal carbon dioxide predicts weight change in children with vomiting and/or diarrhea.

Key Study: Oral Ondansetron Administration to Nondehydrated Children With Diarrhea and Associated Vomiting in Emergency Departments in Pakistan: A Randomized Controlled Trial

Visit

Freedman SB, Soofi SB, Willan AR, Williamson-Urquhart S, Ali N, Xie J, Dawoud...

Objective: To determine whether single-dose oral ondansetron administration to children with vomiting as a result of acute gastroenteritis without dehydration reduces administration of intravenous fluid rehydration.

Key Study: Multicenter Trial of a Combination Probiotic for Children with Gastroenteritis

Visit

Freedman SB, Williamson-Urquhart S, Farion KJ, Gouin S, Willan AR, Poonai N, ...

Objective: To determine whether the use of probiotics improves outcomes in children with gastroenteritis.

Key Study: Efficacy of an Oral Rehydration Solution Enriched with Lactobacillus reuteri DSM 17938 and Zinc in the Management of Acute Diarrhoea in Infants: A Randomized, Double-Blind, Placebo-Controlled Trial

Visit

Maragkoudaki M, Chouliaras G, Moutafi A, Thomas A, Orfanakou A, Papadopoulou A

Objective: to assess the efficacy of an oral rehydration solution enriched with Lactobacillus reuteri DSM 17938 and zinc in well-nourished, non-hospitalized infants with acute diarrhoea.

Key Study: Lactobacillus rhamnosus GG versus Placebo for Acute Gastroenteritis in Children

Visit

Schnadower D, Tarr PI, Casper TC, Gorelick MH, Dean JM, O'Connell KJ, Mahajan...

This study evaluated outcomes for children with acute gastroenteritis who received Lactobacillus rhamnosus GG versus placebo.

Key Study: Performance of Stool Testing Recommendations for Acute Gastroenteritis when Used to Identify Children with Nine Potential Bacterial Enteropathogens

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Tarr GAM, Chui L, Lee BE, Pang XL, Ali S, Nettel-Aguirre A, Vanderkooi OG, Be...

This study evaluated six leading gastroenteritis guidelines for stool testing recommendations.

Key Study: Identification of Enteric Viruses in Oral Swabs from Children with Acute Gastroenteritis

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Zhuo R, Parsons BD, Lee BE, Drews SJ, Chui L, Louie M, Crago B, Freedman SB, ...

This study evaluated if oral swabs are a suitable alternative specimen to stools for identifying enteric viruses from children with acute gastroenteritis.

Key Study: Province-Wide Review of Pediatric Shiga Toxin-Producing Escherichia coli Case Management

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Freedman SB, Eltorki M, Chui L, Xie J, Feng S, MacDonald J, Dixon A, Ali S, L...

Objective: To identify the gaps in the care of children infected with Shiga toxin-producing Escherichia coli, this study sought to quantitate care received and management timelines.

Key Study: Enteropathogen detection in children with diarrhoea, or vomiting, or both, comparing rectal flocked swabs with stool specimens: an outpatient cohort study

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Freedman SB, Xie J, Nettel-Aguirre A, Lee B, Chui L, Pang XL, Zhuo R, Parsons...

Objective: to compare the enteropathogen yields of rectal swabs and stool specimens in children with diarrhoea or vomiting, or both.

Key Study: Implementation of clinical decision support in young children with acute gastroenteritis: a randomized controlled trial at the emergency department

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Geurts D, de Vos-Kerkhof E, Polinder S, Steyerberg E, van der Lei J, Moll H, ...

Objectives: To evaluate feasibility of a nurse-guided clinical decision support system for rehydration treatment in children with AGE, and the impact on diagnostics, treatment, and costs compared with usual care by attending physician.

Key Study: High genetic variability of norovirus leads to diagnostic test challenges

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Zhuo R, Cho J, Qiu Y, Parsons BD, Lee BE, Chui L, Freedman SB, Pang X; Albert...

Objectives: To characterize the cases of discordant norovirus genogroup II (NoV GII) results between Gastrointestinal Pathogen Panel (GPP) and Gastroenteritis Virus Panel (GVP), and determine the sensitivity of the two assays for specific NoV GII genotypes.

Key Study: A randomized trial of Plasma-Lyte A and 0.9 % sodium chloride in acute pediatric gastroenteritis

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Allen CH, Goldman RD, Bhatt S, Simon HK, Gorelick MH, Spandorfer PR, Spiro DM...

Objective: To compare the efficacy and safety of Plasma-Lyte A (PLA) versus 0.9 % sodium chloride (NaCl) intravenous (IV) fluid replacement in children with moderate to severe dehydration secondary to acute gastroenteritis.

Key Study: Evaluating the Impact of Clinical Decision Tools in Pediatric Acute Gastroenteritis: A Population-based Cohort Study

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Bahm A, Freedman SB, Guan J, Guttmann A

This study sought to determine if the following tools - 1) pathways/order sets, 2) medical directives for oral rehydration therapy (ORT) or ondansetron, and 3) printed discharge instructions - are associated with acute gastroenteritis admission and emergency department revisits.

Key Study: Effect of Dilute Apple Juice and Preferred Fluids vs Electrolyte Maintenance Solution on Treatment Failure Among Children With Mild Gastroenteritis: A Randomized Clinical Trial

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Freedman SB, Willan AR, Boutis K, Schuh S

Objective: To determine if oral hydration with dilute apple juice/preferred fluids is noninferior to electrolyte maintenance solution in children with mild gastroenteritis.

Key Study: Oral Ondansetron versus Domperidone for Acute Gastroenteritis in Pediatric Emergency Departments: Multicenter Double Blind Randomized Controlled Trial

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Marchetti F, Bonati M, Maestro A, Zanon D, Rovere F, Arrighini A, Barbi E, Be...

Objective: To evaluate whether a single oral dose of ondansetron vs domperidone or placebo improves outcomes in children with gastroenteritis.

Key Study: Should all acutely ill children in primary care be tested with point-of-care CRP: a cluster randomised trial

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Verbakel JY, Lemiengre MB, De Burghgraeve T, De Sutter A, Aertgeerts B, Shink...

Objective: To determine whether C-reactive protein (CRP) testing should be offered to all acutely ill children in primary care or restricted to those identified as at risk on clinical assessment.

Key Study: Cost-effectiveness of point-of-care testing for dehydration in the pediatric ED

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Whitney RE, Santucci K, Hsiao A, Chen L

Objective: To examine the cost-effectiveness of using point-of-care electrolyte testing vs traditional serum chemistry testing in the pediatric emergency department for children with acute gastroenteritis.

Key Study: Emergency Department Treatment of Children With Diarrhea Who Attend Day Care: A Randomized Multidose Trial of a Lactobacillus helveticus and Lactobacillus rhamnosus Combination Probiotic

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Freedman SB, Sherman PM, Willan A, Johnson D, Gouin S, Schuh S; Pediatric Eme...

This study evaluated the rates of day care absenteeism of children with gastroenteritis treated with probiotics.

Key Study: Impact of increasing ondansetron use on clinical outcomes in children with gastroenteritis

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Freedman SB, Hall M, Shah SS, Kharbanda AB, Aronson PL, Florin TA, Mistry RD,...

The objective of this retrospective study is to determine whether increasing emergency department ondansetron use results in a reduction in intravenous rehydration rates in children with gastroenteritis.

Key Study: Emergency department revisits in children with gastroenteritis

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Freedman SB, Thull-Freedman JD, Rumantir M, Atenafu EG, Stephens D

The aim of the study is to determine whether intravenous fluid administration to children with gastroenteritis is independently associated with a reduction in unscheduled emergency department (ED) revisits within 7 days.

Key Study: Oral ondansetron for gastroenteritis in a pediatric emergency department

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Freedman SB, Adler M, Seshadri R, Powell EC

The aim of this trial is to determine whether a single dose of ondansetron would improve outcomes in children with gastroenteritis.

Key Study: Oral versus intravenous rehydration of moderately dehydrated children: a randomized, controlled trial

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Spandorfer PR, Alessandrini EA, Joffe MD, Localio R, Shaw KN

The objective of this trial is to test the hypothesis that the failure rate of oral rehydration therapy would be not be >5% greater than the failure rate of intravenous fluid therapy for moderately dehydrated children.