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Laura J. Martin, MD
Nov. 22, 2010 -- The voluntary withdrawal of over-the-counter cough and cold medications that cause adverse reactions in babies has resulted in a dramatic decline in accidental overdosing and other problems requiring emergency room treatment, the CDC says in a new study.
Product withdrawals occurred in October 2007 because of worries about the limited evidence of effectiveness and potential harmful effects of nonprescription medicines used by children under age 2, the CDC says in a news release. The medicines withdrawn were orally administered.
The CDC investigators studied hospital emergency room records, looking at ER visits from 63 emergency departments by children younger than 12 for the 14 months before and after products in question were withdrawn.
Emergency room visits related to cough and cold medication for children under 2 fell by more than 50% after the products were withdrawn, from 2,790 in the 14 months before the withdrawal to 1,248 in the 14 months afterward, CDC says.
The overall number of estimated ER visits for this reason in all children under age 12 did not significantly change, however.
Before and after product withdrawal, about two-thirds of all emergency room visits for cough and cold medicines were the result of unsupervised ingestions, CDC says.
The study is published online in advance of the print edition of the December 2010 issue of Pediatrics.
Carl Ramsay, MD acting chairman of emergency medicine at Lenox Hill Hospital in New York, says in a news release that though the study is “not fully comprehensive” in terms of data, he feels the findings “accurately reflect the current message that should be sent to clinicians and caregivers regarding the use of cough and cold medications in patients under 12 years: avoid them.”
He says research has shown that cough and cold medicines are of “little benefit and provide much greater potential for harm.”
However, Ramsay says the study results suggest that doctors and caregivers have, to some extent, avoided using cough and cold medications for children under age 2 since the 2007 withdrawal.
“The responsibility rests with myself and all other clinicians treating patients up to age 12 to educate and direct treatment toward a non-medication management plan,” Ramsay concludes.
The researchers say further reductions in unsupervised ingestion in children likely will require improvements to packaging and better education for adults about the use of nonprescription cough and cold medications.
The researchers say their findings have “important implications for continued efforts to reduce the burden of harm resulting” from nonprescription medicines for colds and cold symptoms.
They also say that parents and other caregivers sometimes misunderstand labeling instructions and are confused by abbreviations for “teaspoon” and “tablespoon,” and that this results in overdosing of some children and then ER visits or calls to poison control centers.
SOURCES:News release, American Academy of Pediatrics.News release, GCI Health.Shehab, N. Pediatrics, December 2010; vol 126: pp 1099-1107.
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