{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T07:10:20Z","timestamp":1788765020536,"version":"build-2803163510"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Acute gastroenteritis (AGE) is a common cause of pediatric emergency visits, and vomiting often complicates oral rehydration. Despite lack of evidence, proton pump inhibitors (PPIs) are sometimes used empirically for persistent vomiting. We evaluated the effect of intravenous pantoprazole on clinical outcomes in children with AGE and persistent vomiting after ondansetron.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      This double-blind, placebo-controlled randomized trial was conducted at Bahrami Children\u2019s Hospital, Tehran, Iran Children aged 4 months to 18 years with AGE and persistent vomiting despite ondansetron were randomized to receive intravenous pantoprazole (2\u00a0mg\/kg\/d) or placebo. Primary outcomes were vomiting frequency, time to oral tolerance, and length of hospital stay. Analyses used the Mann-Whitney\n                      <jats:italic toggle=\"yes\">U<\/jats:italic>\n                      test, the Fisher exact test, and the ordinal logistic regression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of 100 children [51 pantoprazole, 49 placebo; median age 14 months (IQR: 11 to 24), 67% male], there were no significant differences between groups in post-treatment vomiting episodes (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.64), time to oral tolerance at 6 hours (71% vs. 79%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.37) or 12 hours (86% vs. 86%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.78). However, hospital length of stay was significantly longer in the pantoprazole group [median 2 days (IQR: 1 to 3) vs. 1 day (IQR: 1 to 2),\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.01]. Ordinal logistic regression showed that the placebo group had 80% lower odds of prolonged hospitalization (adjusted OR=0.2, 95% CI: 0.09-0.43). Subgroup analyses revealed that this difference was more pronounced in children under 2 years, regardless of reflux history, and in formula-fed children (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.01 for each).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Intravenous pantoprazole does not reduce vomiting or improve oral tolerance in children with acute gastroenteritis. Furthermore, it is associated with longer hospital stays. Empirical PPI use in this setting is not supported by current evidence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/pec.0000000000003693","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T07:00:09Z","timestamp":1788764409000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Effect of Intravenous Pantoprazole on Clinical Outcomes in Pediatric Acute Gastroenteritis: A Placebo-Controlled RCT"],"prefix":"10.1097","author":[{"given":"Armen","family":"Malekiantaghi","sequence":"first","affiliation":[{"name":"Department of Pediatric Gastroenterology, Bahrami Children\u2019s Hospital, School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nastaran","family":"Babajani","sequence":"additional","affiliation":[{"name":"Digestive Diseases Research Center, Digestive Diseases Research Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Behrad","family":"Saeedian","sequence":"additional","affiliation":[{"name":"Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute (DDRI)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3471-2498","authenticated-orcid":false,"given":"Kambiz","family":"Eftekhari","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology, Bahrami Children\u2019s Hospital, School of Medicine, Pediatric Gastroenterology and Hepatology Research Center, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,9,7]]},"reference":[{"key":"R1-20260907","first-page":"159","article-title":"Gastroenteritis in children","volume":"99","author":"Hartman","year":"2019","journal-title":"Am Fam Physician"},{"issue":"RR-16","key":"R2-20260907","first-page":"1","article-title":"Managing acute gastroenteritis among children: oral rehydration, maintenance, and nutritional therapy","volume":"52","author":"King","year":"2003","journal-title":"MMWR Recomm Rep"},{"key":"R3-20260907","doi-asserted-by":"crossref","first-page":"1405","DOI":"10.1016\/S0140-6736(13)60222-6","article-title":"Global burden of childhood pneumonia and diarrhoea","volume":"381","author":"Walker","year":"2013","journal-title":"Lancet"},{"key":"R4-20260907","doi-asserted-by":"crossref","first-page":"e216433","DOI":"10.1001\/jamanetworkopen.2021.6433","article-title":"Variables associated with intravenous rehydration and hospitalization in children with acute gastroenteritis: a secondary analysis of 2 randomized clinical trials","volume":"4","author":"Poonai","year":"2021","journal-title":"JAMA Netw Open"},{"key":"R5-20260907","first-page":"76","article-title":"Lewandowicz-Uszy\u0144ska A. 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