Dehydration secondary to acute
gastroenteritis is a commonly encountered condition among patients presenting to physicians' offices and hospital EDs. Treatment options consist of
oral rehydration therapy (ORT), intravenous
rehydration therapy (IVRT) and subcutaneous
rehydration therapy (SCRT). Although most patients with
dehydration can be effectively treated in an outpatient setting, hospitalization is frequently warranted, with estimated annual inpatient costs for
dehydration therapy exceeding $US1 billion in the US in 1999 for elderly patients alone. Although most treatment guidelines recommend ORT as first-line treatment for mild to moderate
dehydration, IVRT remains the predominant route of administration for
rehydration fluids in the acute care setting in the US. To evaluate the current state of the literature examining costs associated with
dehydration therapy, a systematic review of articles published on MEDLINE from 2000 to 2009 was conducted. A total of 20 reports containing pharmacoeconomic data on
rehydration therapy were evaluated. Findings suggest that ORT and SCRT may be less costly than IVRT in the treatment of mild to moderate
dehydration; however, variability in cost parameters examined or data collection methods described in the literature precluded a comprehensive comparative cost-effectiveness analysis of treatment options. Future pharmacoeconomic analyses of
rehydration therapy should incorporate time-motion analyses comprising a consistent set of variables to determine the most cost-effective treatment modality for patients with mild to moderate
dehydration.