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Adverse events from cough and cold medications in children
Melissa K Schaefer1, Nadine Shehab, Adam L Cohen
1Division of Healthcare Quality Promotion, National Center for Preparedness, Detection, and Control of Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd, NE, Atlanta, GA 30333, USA.
Insights
Emergency departments see thousands of children annually for adverse drug events from cough and cold medications, with unsupervised ingestions being a major concern. Data can guide safety interventions for pediatric medication use.
Area of Science:
- Pediatric Emergency Medicine
- Public Health Surveillance
- Pharmacovigilance
Background:
- Adverse drug events (ADEs) from pediatric cough and cold medications are a significant public health concern.
- National morbidity data is crucial for developing targeted, age-appropriate safety interventions for children.
Purpose of the Study:
- To characterize emergency department (ED) visits for ADEs related to cough and cold medications in children.
- To identify trends and risk factors associated with these pediatric medication-related ED visits.
Main Methods:
- Analysis of a nationally representative sample of 63 US emergency departments.
- Inclusion of pediatric patients (<12 years) with ADEs from cough and cold medications between January 2004 and December 2005.
Main Results:
- An estimated 7,091 pediatric patients annually visited EDs for cough and cold medication ADEs (5.7% of all medication-related ED visits).
- Children aged 2-5 years accounted for the majority of visits (64%).
- Unsupervised ingestions were the primary cause (66% of visits), significantly higher than for other medications, and predominantly involved children aged 2-5 years (77%).
Conclusions:
- National surveillance data is vital for informing educational, enforcement, and engineering strategies to reduce pediatric ADEs.
- Engineering innovations, particularly for child-resistant packaging, are essential to mitigate unsupervised ingestions.
- Findings and interventions may be applicable to other pediatric medications.
Background:
Adverse drug events in children from cough and cold medications have been identified as a public health issue with clinical and policy implications. Nationally representative morbidity data could be useful for targeting age-appropriate safety interventions.
Objective:
To describe emergency department visits for adverse drug events from cough and cold medications in children.
Methods:
Emergency department visits for adverse drug events attributed to cough and cold medications among children aged <12 years were identified from a nationally representative stratified probability sample of 63 US emergency departments from January 1, 2004, through December 31, 2005.
Results:
Annually, an estimated 7091 patients aged <12 years were treated in emergency departments for adverse drug events from cough and cold medications, accounting for 5.7% of emergency department visits for all medications in this age group. Most visits were for children aged 2 to 5 years (64%). Unsupervised ingestions accounted for 66% of estimated emergency department visits, which was significantly higher than unsupervised ingestions of other medications (47%), and most of these ingestions involved children aged 2 to 5 years (77%). Most children did not require admission or extended observation (93%).
Conclusions:
Timely national surveillance data can help target education, enforcement, and engineering strategies for reducing adverse events from cough and cold medications among children. Engineering innovations could be particularly helpful in addressing unsupervised ingestions, which is the most frequent cause of adverse events. These innovations could be applicable to other children's medications.
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