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Restricting cough and cold medicines in children
Geoffrey K Isbister1, Felicity Prior, Henry A Kilham
1Discipline of Clinical Pharmacology, University of Newcastle, Calvary Mater Newcastle, Newcastle, Australia. geoff.isbister@gmail.com
Journal of Paediatrics and Child Health
|July 6, 2010
Summary
Evidence shows limited effectiveness for children's cough and cold medicines. While generally not highly toxic, some medications like diphenhydramine and codeine pose risks, supporting restricted use.
Area of Science:
- Pediatric Pharmacology
- Evidence-Based Medicine
- Public Health
Background:
- International authorities express concerns regarding the safety and efficacy of pediatric cough and cold medications.
- Existing guidelines and recommendations often advise against or are considering restrictions on their use in children.
Purpose of the Study:
- To systematically review the available evidence on the effectiveness and safety of over-the-counter cough and cold medicines for children.
- To inform clinical practice and public health policy regarding the use of these medications in pediatric populations.
Main Methods:
- A systematic literature search was conducted across Medline, Embase, and the Cochrane database.
- Studies included were those investigating treatments for common cold, influenza, or allergic rhinitis symptoms, as well as poisoning/toxicity from unintentional ingestion or overdose in children under 12.
- A meta-analysis was not performed due to limited evidence and the complexity of evaluating both effectiveness and safety.
Main Results:
- Seventy-two studies and clinical reports were identified, revealing minimal support for the effectiveness of these medicines in treating acute cough or the common cold in children.
- Most medications showed low toxicity in children and were not a primary cause of severe effects from unintentional poisoning.
- Therapeutic errors were identified as a significant cause of toxicity, with diphenhydramine and codeine noted for high rates of severe adverse effects.
Conclusions:
- The current evidence supports the restriction of cough and cold medicines for pediatric use.
- Further research may be needed to clarify the risks and benefits of specific agents.
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