Sooo as I was thinking of a highly intellectual article to provide this week…I came across this in the AAP news…

Warnings have little impact on use of OTC cold medicines

It made me think…

FDA put out an public health advisory in 2008 against the use of OTC CCM in children < 2 years, and recently updated this in 2013 confirming their stance after review of available information.  They are still reviewing the safety of OTC CCM in children ages 2-11 years.

http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2008/ucm116839.htm

Despite this I feel like every shift I work I have a parent asking me for this or telling me they always get it from their pediatrician…hmph?!!

According to this article The Impact of Pediatric Labeling Changes on Prescribing Patterns pre and post health advisory, US ED’s either administer, recommend or prescribe OTC CCM at the same rate and ambulatory care centers have increased their use in ages over 2 years, but < 2 years has remained the same.  On the other hand the overall use of prescription CCMs has decreased in both EDs and Ambulatory care.  Of course this is not Pediatric specific providers

Here’s a little help if you don’t know what to say to parents….

There are a wide variety of rare, serious adverse events reported with cough and cold products. They include death, convulsions, rapid heart rates, and decreased levels of consciousness.

AAP position:

• Over-the-counter cough and cold medicines do not work for children under age 6 and, in some cases, may pose a health risk.
• The efficacy and risk of such medications needs to be studied in children. As the AAP has testified: “If a medicine will be used in children, it should be studied in children. Cough and cold medications should not be exceptions to this rule.”
• The labeling needs to reflect what we know: the medications are not effective for children under age 6 and their use, and misuse, could cause serious, adverse side effects.

Speaking points:

• The FDA’s action is a start.
• More needs to be done; the medications efficacy and risks need to be studied in older children.
• Dosage information for these cough and cold medicines is based on adult experience. But children are NOT little adults and studies show their bodies handle the medications differently.
• That simple fact raises the risk of mis-dosing and overdosing.
• Cold symptoms, while annoying and at times uncomfortable, are not dangerous and will go away in time.