Acute gastroenteritis (AGE) in children is very common and accounts for a large number of emergency department visits and hospitalizations [
1]. The most dangerous complication is dehydration, and every year, there are at least 230 deaths and over 87,000 hospitalizations of children under 5 years of age in the European Union [
2]. In Europe, incidence of AGE range from 0.5 to 1.9 episodes per year per person, with a higher risk for children under 3 years [
3]. The management of children diagnosed with AGE is based largely upon international recommendations. The latest European recommendations from European Society for Paediatric Gastroenterology Hepatology and Nutrition/European Society for Paediatric Infectious Disease (ESPGHAN/ESPID) published in 2008 [
3,
4], specify preferred methods of rehydration, possible medications, potentially useful laboratory tests, and suggested nutrition in cases of AGE. These recommendations clearly state that the first line of treatment should include oral rehydration with standard Oral Rehydration Solution (ORS), the composition of which is specified within the same recommendations [
3]. In contrast, treatment recommendations are less strict regarding second line treatments. Indeed, recommendations indicate that the nasogastric (NG) and intravenous (IV) routes can both be used to rehydrate individuals with AGE even though the recommendations additionally state that the NG route is associated with less adverse events and shorter hospitalizations [
5,
6]. They also clearly state that there is no need for microbiological investigation since the epidemiology of AGE is well known in Europe [
3]. These recommendations, however, do not take into account the most recent studies on AGE treatments, such as the study of ondansetron by Carter
et al.[
7]. Where guidelines are vague or evidence is limited, wide variations in the management of AGE have been observed among institutions and countries [
8,
9]. Because an accurate understanding of current treatment regimens is a necessary prerequisite to developing improvements, we sought to assess variations in the management of pediatric AGE across Europe.
Our primary objective was to determine the extent to which significant variations in rehydration therapies for individuals with pediatric gastroenteritis exist among pediatric emergency departments (PEDs) in Europe. Secondary objectives included the assessment of variations in the use of additional therapeutic and diagnostic modalities.