Update on nonantibiotic therapies for acute gastroenteritis.

Abstract:

PURPOSE OF REVIEW:The aim of this review is to provide an update of nonantibiotic therapies for acute gastroenteritis (AGE), focusing on antiemetics and probiotics. RECENT FINDINGS:The mainstay of therapy for nonsevere AGE remains oral rehydration therapy (ORT). Recent randomized controlled trials and metaanalyses have further strengthened the evidence-base supporting single-dose ondansetron administration in emergency departments to facilitate ORT based on evidence that it safely reduces intravenous fluid administration and hospitalization rates. Intravenous ondansetron administration and multiple-dose use should be avoided. A bimodal release ondansetron formulation was shown to improve outcomes in adolescents and adults with AGE in one study, but further evidence is required to support use. Recent large trials evaluating probiotic administration demonstrated a lack of benefit and guidelines that recommend their use should reevaluate their positions in light of this evidence. Furthermore, caution should be exercised when use is considered in high-risk populations and settings. SUMMARY:The benefits, dosing/route, and target populations most likely to benefit from ondansetron have been further clarified. Optimization of the real-life effectiveness of this therapy will require implementation strategies. Recent high-quality evidence showing a lack of efficacy and potential harm associated with probiotic use suggests that routine use for AGE should be discouraged.

journal_name

Curr Opin Infect Dis

authors

Funk A,Schnadower D,Freedman SB

doi

10.1097/QCO.0000000000000670

subject

Has Abstract

pub_date

2020-10-01 00:00:00

pages

381-387

issue

5

eissn

0951-7375

issn

1473-6527

journal_volume

33

pub_type

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