Benefits of domperidone in ambulatory acute diarrhea with severe vomiting
AbstractBackground 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
â€œcentralâ€ 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
Conclusion Domperidone significantly shortened the duration and
decreased the frequency of vomiting in DD cases.
2. Rachman KN. Mekanisme kematian penderita penyakit diare
yang dirawat di UPF Penyakit Anak RSUP Palembang selama
tahun 1989 [Thesis]. Palembang: Bagian IKA RSUP/FK
3. Sunoto, Soeparto PSW, Soenarto Y, Ismail R. Buku ajar diare.
Jakarta: Dep Kes RI Ditjen PPM & PLP;1990. p. 1-164.
4. Thacker SB, Goodman RA. The management of acute
diarrhea in children: oral rehydration, maintenance and
nutritional therapy. Atlanta: Center for Disease Control and
Prevention; 1992. p. 41-60.
5. Brogden RN, Carmine A, Heel RC, Speight TM, Avery GS.
Domperidone. A review of its pharmacological activity,
pharmacokinetics a therapeutic efficacy in the symptomatic
treatment of chronic dyspepsia and as an antiemetic. Drugs
6. Kovac AL. Prevention and treatment post operative of
nausea and vomiting. Drugs 2000;59:213-43.
7. De Loore, Ravensteyn V, Ameryckx L. Domperidone in the
treatment of pediatric chronic vomiting and regurgitation:
A comparison with metoclopramide. Postgrad Med J
8. Bines JE, Quinlan JE, Treves S, Kleinman RE, Winter HS.
Efficacy of Domperidone in infants and children with
gastroesophageal reflux. J Pediatr Gastroenterol Nutr
9. WHO. A manual for the treatment of diarrhea. For use by
physicians and other senior health workers. Geneva: WHO;
10. Murphy M S. Guidelines for managing acute gastroenteritis
based on a systematic review of published research. Arch
Dis Child 1998;79:279-84.
11. Hirschhorn N. Oral rehydration therapy and early refeeding
in the management of childhood gastroenteritis. Can J Paed,
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.