From the Guidelines
Management for an 11-year-old girl with suspected food poisoning should focus on preventing dehydration through oral rehydration therapy, and the most recent guidelines from 2017 support this approach 1. The primary goal is to prevent dehydration by offering small, frequent sips of clear fluids like water, diluted fruit juices, or oral rehydration solutions such as Pedialyte.
- Once she can tolerate fluids, gradually reintroduce bland foods like bananas, rice, applesauce, toast, and crackers (BRAT diet).
- Avoid dairy products, fatty foods, and sugary items until symptoms resolve.
- Medication is generally not necessary, but acetaminophen (10-15 mg/kg every 4-6 hours, not exceeding 5 doses in 24 hours) can help with fever or discomfort, as suggested by the guidelines 1.
- Anti-diarrheal medications should be avoided in children with suspected infectious gastroenteritis as they can prolong the infection, according to the Infectious Diseases Society of America clinical practice guidelines 1.
- Monitor for warning signs requiring immediate medical attention: severe abdominal pain, bloody diarrhea, persistent vomiting preventing fluid intake, signs of dehydration (decreased urination, dry mouth, sunken eyes, lethargy), high fever (>102°F or 38.9°C), or symptoms lasting more than 2-3 days.
- For patients with suspected food protein-induced enterocolitis syndrome (FPIES), treatment should be individualized according to severity, and aggressive fluid resuscitation may be necessary in severe cases, as recommended by the international consensus guidelines 1. Most cases of food poisoning resolve within 24-48 hours with supportive care as the body naturally eliminates the toxins or pathogens causing the illness.
From the Research
Management of Suspected Food Poisoning in an 11-year-old Girl
- The management of suspected food poisoning in children typically involves oral rehydration therapy (ORT) to prevent dehydration and electrolyte imbalances 2, 3.
- According to a study published in the Annals of Emergency Medicine, oral ondansetron can facilitate oral rehydration therapy in children with acute gastritis or gastroenteritis who have failed initial oral rehydration therapy 4.
- Another study published in The Journal of Pediatrics found that a single dose of oral ondansetron can improve oral rehydration in children aged 3 months to 5 years with acute diarrhea and vomiting 5.
- The use of oral rehydration solution (ORS) is the cornerstone of therapy for dehydration secondary to acute infectious diarrhea, and its efficacy is based on the ability of glucose to stimulate sodium and fluid absorption in the small intestine 2, 3.
Key Considerations
- Oral rehydration therapy should be initiated as soon as possible to prevent dehydration and electrolyte imbalances.
- Ondansetron can be considered in children who have failed initial oral rehydration therapy or have persistent vomiting.
- The choice of oral rehydration solution and the use of ondansetron should be guided by the severity of dehydration, the presence of vomiting, and the child's overall clinical condition 4, 5.