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Thursday, January 31, 2008

Cough and Cold Medicines put 7,000 American Children a Year in The Emergency Department

Over 7,000 children in the US end up in emergency departments every year because of complications from taking cough and cold medicines, found researchers who did a nationwide study of the problem. They said there is an urgent need for fresh ideas to tackle the problem, especially since the largest proportion of emergency cases are the result of children getting hold of and taking cough and cold medicines unsupervised.

The study was carried out by researchers from the US Centers for Disease Control and Prevention (CDC) and is published in the 28th January online issue of Pediatrics.

The researchers, led by Daniel S. Budnitz, observed that adverse events resulting from children ingesting cough and cold drugs is a not insignificant public health problem, and decided to investigate this on a national level, to help policy makers and health professionals put together age-appropriate measures to tackle the issue.

They looked at records dated from the beginning of 2004 to the end of 2005, of adverse events related to cough and cold medications in children under 12 years of age from 63 US emergency departments.

The results showed that:

* An estimated 7,091 children under 12 were treated every year in emergency departments for adverse events related to cough and cold medications.

* This number accounts for 5.7 per cent of emergency department visits for all medications in this age group.

* Most of the visits (64 per cent) were by children aged between 2 and 5 years.

* Most of the visits were caused by children taking the medications by themselves (66 per cent).

* This is significantly higher than the proportion of "unsupervised ingestions" recorded for other medications (47 per cent).

* Also, most of the unsupervised ingestions of cough and cold medicines that led to emergency department visits were by children aged between 2 and 5 (77 per cent).

* The vast majority of children (93 per cent) did not require hospitalization or extended observation.

The researchers concluded that:

"Timely national surveillance data can help target education, enforcement, and engineering strategies for reducing adverse events attributable to cough and cold medications among children."

They suggested that preventing children taking cough and cold remedies without supervision was the area that most needed fresh ideas, since this was the biggest cause of adverse events. The ideas could also be applied to other children's medication.

This comes in the wake of a new Public Health Advisory from the US Food and Drug Administration (FDA) recommending children under 2 years of age are not given over the counter cough and cold medicines, because of question marks over their effectiveness and safety.

The FDA said it is also reviewing the case for making such a recommendation for older children and will make a further announcement when it has completed its evaluation of OTC cough and cold medications in older populations.

This study received a warm welcome from a number of groups concerned about what they describe as the high risk versus the questionable benefits of cough and cold medicines for young children.

Speaking to the Washington Post, Baltimore's public health commissioner, Joshua M. Sharfstein, who led the group that petitioned the FDA to restrict marketing of the medicines for children, said it was time to pull the plug on these products, commenting that:

"This is a lot of trips to the emergency room for products that have no known benefit."

Industry representatives on the other hand, pointed to lack of parental understanding about the right dose, or failing to keep the medicines out of the reach of children, as the main problem, and that the products were safe and effective when used correctly.

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