Cold and cough medications (CCMs) have been linked to a high number of emergency department visits and rare cases of deaths in infants and children. It is for this reason that manufacturers and government agencies stopped recommending these medications be used for children less than four years of age. In 2007, manufacturers voluntarily withdrew infant cough and cold medications sold over the counter from the US market. In 2008, the US government acted to revise labels of over the counter CCMs to warn against use by children < 4 years. These new recommendations and labeling revisions have been followed by efforts to educate parents about the dangers of giving over the counter CCMs to infants.
A recent study in the journal Pediatrics confirms that these labeling changes and new recommendations have led to a decrease in emergency department visits. Out of all the emergency visits for infants aged <2 years, the percentage of adverse drug events (ADEs) related to cough and cold medications decreased from 4.1% of total ADEs before the market withdrawal to 2.4% afterward—an almost 50% reduction. Presumably this reduction in ADEs is the result of fewer parents buying and administering cold and cough medications to children in the under three-year old age group. This is all great news. Cold and cough medications don’t cure or even shorten respiratory illness, providing at best, symptom relief for a brief time.
The study in Pediatrics revealed another major problem with CCMs in young children, that of unsupervised toxic ingestions. . These unsupervised ingestions accounted for about two thirds of emergency department visits related to CCMs after the market withdrawal. That seems logical since children are tempted to reach for the medicine drawer and accidently drink sweet brightly colored cold medications. The problem of unsupervised ingestions is a problem that falls squarely on parent’s shoulders. Vigilance is need by parents to make sure all medications are kept out of the sight and reach of children with the packaging securely closed and locked. With the combined efforts of manufacturers, physicians, and parents, the problem of accidental overdose of CCMs might just completely disappear. Wouldn’t that be a great thing.
Your comments are welcome at my blog, www.docsmo.com. If you have insights you would like to share please take a moment to weigh in. Until next time.
Written collaboratively by Catherine Wu and Paul Smolen MD