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Acetaminophen and aspirin. Prescription, use, and accidental ingestion among children
Insights
Physicians and parents reduced acetaminophen and aspirin use in children due to safety concerns. Acetaminophen prescriptions increased then decreased, while aspirin use saw a decline, particularly before hospital admission.
Area of Science:
- Pediatric pharmacology
- Drug safety surveillance
- Public health epidemiology
Background:
- Acetaminophen and aspirin are common antipyretics for children.
- Concerns exist regarding the toxic effects of aspirin and the hepatotoxic potential of acetaminophen overdose.
- Understanding trends in pediatric analgesic use is crucial for public health.
Purpose of the Study:
- To analyze trends in acetaminophen and aspirin prescribing and use among hospitalized children.
- To investigate changes in the utilization of these analgesics over time.
- To correlate drug use patterns with safety concerns and poison control center data.
Main Methods:
- Retrospective analysis of data from the Pediatric Drug Surveillance Program (1974-1979).
- Inclusion of 3,587 hospitalized children's medication records.
- Examination of poison control center call data for aspirin and acetaminophen.
Main Results:
- Acetaminophen prescriptions increased from 1975-1977, then decreased; aspirin prescriptions remained stable among inpatients.
- Preadmission use of acetaminophen increased then decreased, while preadmission aspirin use significantly declined.
- Poison control calls for acetaminophen increased by 87%, while aspirin calls rose by 36%.
Conclusions:
- Physician and parental concerns about drug toxicity may be influencing prescribing and usage patterns.
- The study highlights a potential shift away from both aspirin and acetaminophen for pediatric fever management.
- Ongoing surveillance is necessary to monitor the impact of safety concerns on medication use in children.
Abstract:
Among 3,587 hospitalized children monitored by the Pediatric Drug Surveillance Program between 1974 and 1979, acetaminophen was prescribed for 32% and aspirin for 3%. In the three months before admission, 23% reported use of either drug. In both inpatient and preadmission settings, acetaminophen use increased between 1975 and 1977 and decreased subsequently. Aspirin prescriptions were consistent over the entire study period among inpatients, but preadmission use decreased substantially. The Massachusetts Poison Information Center observed a 36% increase in calls concerning aspirin from 1976 to 1977 and 1977 to 1978, similar to the increase in all calls, but acetaminophen calls increased by 87%. Long-standing concerns about the toxic effects of aspirin, coupled with recent concerns about hepatotoxic effects of acetaminophen in overdose, may be leading physicians and parents to decrease the use of both drugs for the treatment of fever.