Cough and cold medication use by US children, 1999-2006: results from the slone survey.
OBJECTIVE
Pediatric cough and cold medications are widely marketed in the United States, but the precise patterns of use among children are not known. Such information is especially important given recent reports suggesting that these medications are responsible for previously underappreciated serious adverse events and deaths among children. We sought to describe the prevalence and patterns of pediatric use of cough and cold medications, with particular attention to use among young children.


METHODS
We analyzed data on the use of cough and cold medications, defined as any oral medication that contains >or=1 antitussive, decongestant, expectorant, and/or first-generation antihistamine active ingredients, among 4267 US children who were younger than 18 years and enrolled during 1999-2006 in the Slone Survey, a national random-digit-dial telephone survey of medication use by the US population.


RESULTS
In a given week, a cough and cold medication was used by 10.1% of US children. Exposure was highest to decongestants (6.3%; mostly pseudoephedrine) and first-generation antihistamines (6.3%; most common were chlorpheniramine, diphenhydramine, and brompheniramine), followed by antitussives (4.1%; mostly dextromethorphan) and expectorants (1.5%; almost exclusively guaifenesin). Multiple-ingredient products accounted for 64.2% of all cough and cold medications used. Exposure to antitussives, decongestants, and first-generation antihistamines was highest among 2- to 5-year-olds (7.0%, 9.9%, and 10.1%, respectively) followed by children who were younger than 2 years (5.9%, 9.4%, and 7.6%, respectively); expectorant use was low in all age groups. The use of cough and cold medications declined from 1999 through 2006.


CONCLUSIONS
Approximately 1 in 10 US children uses a cough and cold medication in a given week. The especially high prevalence of use among children of young age is noteworthy, given concerns about potential adverse effects and the lack of data on the efficacy of cough and cold medications in this age group.
Vernacchio
Louis
L
Slone Epidemiology Center at Boston University, 1010 Commonwealth Ave, Boston, MA 02115, USA. lvernacchio@slone.bu.edu
Kelly
Judith P
JP
Kaufman
David W
DW
Mitchell
Allen A
AA
D000284:Administration, Oral; D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D003139:Common Cold / Q000175:diagnosis / Q000188:drug therapy*; D016001:Confidence Intervals; D003371:Cough / Q000175:diagnosis / Q000188:drug therapy*; D003430:Cross-Sectional Studies; D004338:Drug Combinations; D005100:Expectorants / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D014663:Nasal Decongestants / Q000008:administration & dosage / Q000009:adverse effects; D004366:Nonprescription Drugs / Q000008:administration & dosage* / Q000009:adverse effects; D015995:Prevalence; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D014481:United States; D014486:United States Food and Drug Administration
D004338:Drug Combinations; D005100:Expectorants; D014663:Nasal Decongestants; D004366:Nonprescription Drugs