title: Adverse events from cough and cold medications after a market withdrawal of products labeled for infants.
abstract: OBJECTIVE
  A voluntary market withdrawal of orally administered, over-the-counter, infant cough and cold medications (CCMs) was announced in October 2007. The goal of this study was to assess CCM-related adverse events (AEs) among children after the withdrawal.
  
  
  METHODS
  Emergency department (ED) visits for CCM-related AEs among children <12 years of age were identified from a nationally representative, stratified, probability sample of 63 US EDs, for the 14 months before and after announcement of withdrawal.
  
  
  RESULTS
  After withdrawal, the number and proportion of estimated ED visits for CCM-related AEs involving children <2 years of age were less than one-half of those in the prewithdrawal period (1248 visits [13.3%] vs 2790 visits [28.7%]; difference: -15.4% [95% confidence interval [CI]: -25.9% to -5.0%]), whereas the overall number of estimated ED visits for CCM-related AEs for children <12 years of age remained unchanged (9408 visits [95% CI: 6874-11 941 visits] vs 9727 visits [95% CI: 6649-12 805 visits]). During both periods, two-thirds of estimated ED visits involved unsupervised ingestions (ie, children finding and ingesting medications).
  
  
  CONCLUSIONS
  ED visits for CCM-related AEs among children <2 years of age were substantially reduced after withdrawal of over-the-counter infant CCMs. Further reductions likely will require packaging improvements to reduce harm from unsupervised ingestions and continued education about avoiding CCM use for young children. Monitoring of CCM-related harm should continue because recommendations were updated in October 2008 to avoid the use of CCMs for children <4 years of age.
authors.affiliation: Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd, NE, Mailstop A-24, Atlanta, GA 30333, USA.
authors.forename: Nadine
authors.initials: N
authors.lastname: Shehab
authors.forename: Melissa K
authors.initials: MK
authors.lastname: Schaefer
authors.forename: Scott R
authors.initials: SR
authors.lastname: Kegler
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Budnitz
mesh_terms: D000996:Antitussive Agents / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D003139:Common Cold / Q000150:complications / Q000188:drug therapy*; D003371:Cough / Q000188:drug therapy* / Q000209:etiology; D004348:Drug Labeling; D064420:Drug-Related Side Effects and Adverse Reactions; D005100:Expectorants / Q000494:pharmacology*; D005260:Female; D006801:Humans; D008297:Male; D014663:Nasal Decongestants / Q000494:pharmacology*; D004366:Nonprescription Drugs / Q000494:pharmacology; D057051:Product Recalls and Withdrawals
chemical_list: D000996:Antitussive Agents; D005100:Expectorants; D014663:Nasal Decongestants; D004366:Nonprescription Drugs