Benefits of domperidone in ambulatory acute diarrhea with severe vomiting

Abstract

Background Recently, most patients with diarrheal disease (DD)
cases are hospitalized not due to severe dehydration, but due to
severe vomiting which interferes with fluid and food intake. Use
of anti-vomiting medicines is not recommended because of its
“central†side effects. Domperidone has prokinetic and antiemetic
effects with only minimal extrapyramidal side effects.
Objective To evaluate domperidone in preventing hospitalization
of DD patients in outpatient setting.
Methods This randomized double blind, placebo-controlled
clinical trial, was conducted from February to August 2005 at
Mohammad Hoesin Hospital, Palembang. We included patients
aged 6 to 59 months old with acute diarrhea who had vomited at
least 4 times in the last 24 hours, not in need of hospitalization,
and agreed to participate. We excluded patients who had taken
anti-vomiting drug, or those who had severe diseases, including
severe malnutrition. The dose of domperidone was 1.25 mg per 5
kg body weight.
Results There were 183 subjects randomized, consisted of 91 who
took domperidone (treatment group) and 92 who took placebo
(control group). The duration and decrease of vomiting frequency
were significantly different in favor of domperidone. Domperidone
prevented hospitalization significantly (P=0.001, OR=4.1, ARR
= 20%, RRR=71%, NNT=5). No overt acute clinical side effects
were found.
Conclusion Domperidone significantly shortened the duration and
decreased the frequency of vomiting in DD cases.