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Cold Meds Send 7,000 U.S. Kids to ER Each Year

Most cases due to accidental ingestion, study finds

MONDAY, Jan. 28, 2008 (HealthDay News) -- Some 7,000 American children under the age of 11 are treated each year in hospital emergency rooms because of problems with cough and cold medications, the U.S. Centers for Disease Control and Prevention reported Monday.

"In the majority of cases, these ER visits are due to unsupervised ingestion," said study lead author Dr. Melissa K. Schaefer, of the CDC's Division of Healthcare Quality Promotion.

The 7,000 cases are just under 6 percent of emergency room visits from all other medications combined, Schaefer said. "Any medication in the hand of a 3-year-old is a problem," she said. "It is important to focus on this, because these are all preventable emergency department visits."

In the study, released early by the journal Pediatrics and published online Monday, researchers used data from the National Electronic Injury Surveillance System-Cooperative Adverse Drug Event Surveillance project to analyze emergency department visits due to cough and cold medications in 2004 and 2005.

They found that children aged 2 to 5 years old made up 64 percent of all emergency department visits for adverse reactions to cough and cold medications. Among these youngest children, 80 percent of the problems arose from unsupervised ingestions. Overall, roughly two-thirds of all the children studied wound up in the ER because of unsupervised ingestion.

Most of the children, 93 percent, did not need to be admitted to the hospital. But, one-fourth needed additional treatment to get the medicine out of their system, the researchers reported.

The over-the-counter cough and cold products the researchers reviewed in the study included decongestants, expectorants and antitussives. The products may also have included antihistamines. Labels could include the terms "nasal decongestants," "cough suppressants," "expectorants" and "antihistamines."

Earlier this month, the U.S. Food and Drug Administration issued a public health advisory stating that over-the-counter cough and cold medicines should not be given to infants and children under the age of 2. The safety of these products for children ages 2 to 11 is currently being reviewed by the FDA.

Right before the FDA held an advisory committee meeting in October that ultimately led to a recommendation for a ban on cold medicines for children under the age of 2, the makers of dozens of cough and cold remedies targeted to infants voluntarily recalled some of these products. Overall, there are approximately 800 popular cough and cold medicines sold in the United States. Experts estimate that Americans spend about $2 billion annually on these types of medications.

The CDC cautioned that parents also should not use products intended for older children to treat young children, and should keep all cough and cold medications out of the reach of children. In addition, parents should throw out products they may have that were sold to be used for infants and toddlers aged 2 and younger.

The CDC's Schaefer thinks that parents need to be educated about the dangers of letting children get their hands on these medications. In addition, Schaefer's team recommends that the makers of these drugs redesign their packaging to make it impossible for children to open these drugs.

"Parents should not substitute medications meant for older children for children under 2," Schaefer said. "In addition, parents should not tell children these medications are candy, and they should not take their own medications in front of their children."

The head of the drug industry group the Consumer Healthcare Products Association said the new study underscores the safety of these products when used properly.

"This CDC review puts the overall discussion of pediatric cough and cold remedies into perspective by focusing on concrete data that address the real issue," Linda A. Suydam, president of the Consumer Healthcare Products Association, said in a statement. "These medicines are safe when used as directed, and this government review underscores the importance of educating consumers -- especially those with small children -- on the safe use and safekeeping of medicine."

One expert sees no reason for parents to give children these medicines in the first place.

"There is no evidence that these medicines work to make you better faster," said Dr. Karen Sheehan, medical director of injury prevention and research at Children's Memorial Hospital in Chicago, and medical director of the Injury Free Coalition for Kids. "There is no reason to make them available, because we know bad things can happen to kids."

The way to treat a child with a cold is to make the child comfortable, give Tylenol for fever, lots of liquids and use a humidifier, Sheehan said. "The kids have the ability [to get better] on their own," she said.

More information

For more on coughs and colds, visit the American Lung Association.

SOURCES: Melissa K. Schaefer, M.D., Division of Healthcare Quality Promotion, National Center for Preparedness, Detection, and Control of Infectious Diseases, Coordinating Center for Infectious Diseases, U.S. Centers for Disease Control and Prevention; Karen Sheehan, M.D., medical director, Injury Prevention and Research, Children's Memorial Hospital, Chicago, and medical director, Injury Free Coalition for Kids; Jan. 28, 2008, statement, U.S. Centers for Disease Control and Prevention; Jan. 28, 2008, statement, Consumer Healthcare Products Association; Jan. 28, 2008, Pediatrics, online
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