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Unsupervised Use of Cold Medicine Sending Children to the ER

Apr 11, 2008 | Parker Waichman LLP

Researchers at the Centers for Disease Control and Prevention (CDC) estimate that the majority of children’s emergency room (ER) visits for side effects linked with taking cough and cold medicines are a result of unsupervised ingestion of these medicines.  The CDC findings are reported in the journal Pediatrics.  Data estimating the illness rates in children taking cough and cold medications could be useful in targeting age-related interventions.

Side effects "in children from cough and cold medications have been identified as a public health issue with clinical and policy implications," Dr. Daniel S. Budnitz and colleagues from the CDC in Atlanta, write.   In the current study, the researchers identified ER visits for cough and cold medicine-related side effects among children younger than 12 years of age who were taken from a sample of 63 US ERs from 2004 to 2005.  From this, the team estimates that 7,091 children visited ERs annually for side effects resulting from taking cough and cold medications, accounting for 5.7 percent of ER visits for all side effects in this age group.  The investigators also report that the majority—64 percent—of ER visits related to cough and cold medications involved children between the ages of two and five and, again, the majority—66 percent—of the estimated ER visits were due to unsupervised ingestion of cough and cold medications, most common among children in the two-to-five year age range.  The vast majority of the children—93 percent—were treated and released while 23 percent underwent stomach decontamination.

"As long as these products continue to be marketed for use in children, additional safety interventions should address the primary cause of injuries from these products: unsupervised ingestions which are a particular safety concern in two-to-five-year olds," Budnitz and colleagues state.  "Although cough and cold medications represent a small proportion of all emergency department visits for side effects among pediatric patients," they conclude, "focus on these medications highlights how targeted strategies, particularly packaging innovations, could reduce pediatric side effects from other medications."

Meanwhile, the U.S. Food and Drug Administration (FDA) recently issued a warning for parents that over the counter (OTC) cough and cold medicines are dangerous for children under the age of two.  The CDC’s study's findings on properly dosed kids who end up in the ER is expected to contribute to FDA discussions about cough and cold drug recommendations in the two-to-six age group, CDC officials said.  Approximately 1,600 of the estimated 7,100 children are under two years of age; therefore, if FDA recommendations are followed, ER cases should fall 23 percent.

"The main message is, no medication left in the hands of a 3-year-old is safe," said the CDC's Dr. Melissa Schaefer an epidemiologist.  For children whose symptoms were reported, allergic reactions such as hives and itching were most common; neurological symptoms such as drowsiness and unsteady walking were reported as the second most common.  The medicines involved were generally liquid combinations of cough and cold treatments.

The CDC urges parents to avoid taking adult medications in front of children and to avoid encouraging children to take medicine by telling them it's candy.


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