ER visits among young kids plummet after removal of cold medicines, study says
Mary Forgione, For the Los Angeles Times
November 22, 2010|12:59 p.m.
ER visits for children younger than 2 years old who experienced bad reactions to cough and cold medicines plummeted since the products were removed from store shelves, media reports of a new study say.
These over-the-counter medicines are are no longer recommended for children younger than 4 because of accidental overdoses that sickened kids and even resulted in some deaths, this Associated Press story says. The study about emergency room visits appeared in the journal Pediatrics.
The problem isn’t limited to infants and toddlers.
Thousands of kids 12 and younger show up in ERs after having taken such medicines unsupervised, the Centers for Disease Control and Prevention reports. Here’s what the CDC has to say about throwing out and storing over-the-counter cold and cough meds.
Clearly a child overdosing on any medication warrants an ER visit. But when else should you take your kid to an ER? This advice from Kidshealth.org offers guidelines on everything from when to handle an emergency at home to calling 911. And this primer from FamilyDoctor.org includes how to tell when fevers in infants and children turn serious -- particularly handy as we head into flu season.
Copyright (c) 2010, Los Angeles Times
Kids' ER visits fell after cold medicines' removal
(AP) -- 19 hours ago
CHICAGO (AP) ― Removing cough and cold medicines for very young children from store shelves led to a big decline in emergency room visits for bad reactions to the drugs, government research found.
But the results released online Monday are a mixed bag: Some parents were still giving their infants and toddlers these medicines, and many ER cases still involved youngsters who apparently got hold of the medications themselves.
That suggests parents who stopped using them hadn't discarded old bottles or kept them out of reach after manufacturers voluntarily withdrew medicines labeled for infants and kids up to age 2 in 2007.
The bottom-line message: "Keep all medicines up and away and out of sight," said Dr. Daniel Budnitz, the study's senior author and a researcher at the Centers for Disease Control and Prevention.
Budnitz said the results also indicate the need for better childproof containers.
The study appears in the journal Pediatrics.
Makers of over-the-counter cough and cold medicines voluntarily withdrew the products, mostly syrups, in October 2007. Pediatricians had complained that the products don't work in young kids and posed a safety risk because of accidental overdoses causing extreme drowsiness, increased heart rate and even some deaths.
The Food and Drug Administration in 2008 warned against using the medicines in children younger than 2; labels now advise against using them in children younger than 4, Budnitz noted.
CDC researchers compared nonfatal ER visits in children younger than 2 with bad reactions to cough and cold medicines in the 14 months before the withdrawal and in the 14 months afterward. A total of 63 nationally representative hospitals were involved.
Extrapolating, the number of visits nationwide linked with cough and cold medicine dropped by more than half, from 2,790 visits to 1,248, the researchers found.
However, two-thirds of the cases before and after involved kids taking medicine on their own.
Dr. Elizabeth Powell, an ER physician at Chicago's Children's Memorial Hospital, called that result disappointing but said it may have taken a while for parents to get the message "so these things aren't laying around the house."
The removal left many parents feeling helpless about relieving their children's cold symptoms. Powell said parents often bring babies with stuffy noses and other cold symptoms to the emergency room seeking help. She tells them there's little doctors can do other than suggesting parents remove excess mucous with a bulb device and try acetaminophen (Tylenol) or ibuprofen for comfort.
On the Net:
* American Academy of Pediatrics: http://www.aap.org
Copyright (c) 2010 The Associated Press. All rights reserved.
Published online November 22, 2010
Adverse Events From Cough and Cold Medications After a Market Withdrawal of Products Labeled for Infants
Nadine Shehab, PharmD, MPHa, Melissa K. Schaefer, MDa, Scott R. Kegler, PhDb, Daniel S. Budnitz, MD, MPHa
aDivision of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, and
bOffice of Statistics and Programming, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
Objective A voluntary market withdrawal of orally administered, over-the-counter, infant cough and cold medications (CCMs) was announced in October 2007. The goal of this study was to assess CCM-related adverse events (AEs) among children after the withdrawal.
Methods Emergency department (ED) visits for CCM-related AEs among children <12 years of age were identified from a nationally representative, stratified, probability sample of 63 US EDs, for the 14 months before and after announcement of withdrawal.
Results After withdrawal, the number and proportion of estimated ED visits for CCM-related AEs involving children <2 years of age were less than one-half of those in the prewithdrawal period (1248 visits [13.3%] vs 2790 visits [28.7%]; difference: --15.4% [95% confidence interval [CI]: --25.9% to --5.0%]), whereas the overall number of estimated ED visits for CCM-related AEs for children <12 years of age remained unchanged (9408 visits [95% CI: 6874--11 941 visits] vs 9727 visits [95% CI: 6649--12 805 visits]). During both periods, two-thirds of estimated ED visits involved unsupervised ingestions (ie, children finding and ingesting medications).
Conclusions ED visits for CCM-related AEs among children <2 years of age were substantially reduced after withdrawal of over-the-counter infant CCMs. Further reductions likely will require packaging improvements to reduce harm from unsupervised ingestions and continued education about avoiding CCM use for young children. Monitoring of CCM-related harm should continue because recommendations were updated in October 2008 to avoid the use of CCMs for children <4 years of age.
Key Words: adverse events . drug safety . poisoning . medication errors . drug packaging . nasal decongestants . expectorants . antitussive agents . product withdrawals . nonprescription drugs
Abbreviations: AE = adverse event . CCM = cough and cold medication . CI = confidence interval . ED = emergency department . FDA = Food and Drug Administration . NEISS = CADES-National Electronic Injury Surveillance System-Cooperative Adverse Drug Event Surveillance . OTC = over-the-counter
Accepted Aug 31, 2010.
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