title: Pediatrician's cough and cold medication prescription for hypothetical cases - A cross-sectional multi-centric study.
abstract: BACKGROUND
  Concerns over inappropriate use of cough and cold medication (CCM) in children have been raised. In addition to being ineffective, these are now considered toxic for young children. Despite this fact studies from some regions have shown high use of these medications by physicians. However data on pediatricians and from India are negligible.
  
  
  OBJECTIVE
  To study the burden and patterns of cough and cold medications use by pediatricians for hypothetical cases.
  
  
  METHODS
  In this cross-sectional study; 172 pediatricians of various hospitals of Delhi and Haryana were enrolled from February 15 to March 15, 2012. They were contacted personally by authors and asked to write their prescriptions for two hypothetical case scenarios [having cough and cold] of two different age groups; (1) less than 2 years and (2) 2-5 years. We made two categories as recommendations exist for children less than 2 years while recommendations for the second category are underway. RESULTS were summarized as percentages, counts and; presented in tables and figures. Chi square test was used to establish association between categorical variables of subgroups.
  
  
  RESULTS
  Response rate was 93%. The most used CCM was antihistaminics (82%) and systemic sympathomimetics (48%). The use of CCM was significantly less in teaching hospitals as compared to non-teaching (77% vs. 95%; p-value - 0.025). However there was no statistical difference in the practice of post graduates and more senior pediatricians (p value-0.895). No difference in CCM use in two age groups {(82% (less than 2 years) vs. 85% (2-5 years); p-value - 0.531} was observed.
  
  
  CONCLUSIONS
  Overall use of CCM is still high irrespective of patient age, pediatrician's seniority or hospital setting. Efforts should be made to create awareness among the pediatricians regarding cautious use of these medications.
authors.affiliation: Department of Pediatrics, Critical Care Division, Pt. B.D. Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India.
authors.forename: Sudha
authors.initials: S
authors.lastname: Chandelia
authors.affiliation: Department of Pediatrics, Critical Care Division, Pt. B.D. Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India.
authors.forename: Mukesh
authors.initials: M
authors.lastname: Dhankar
authors.affiliation: Department of Pediatrics, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
authors.forename: Meetu
authors.initials: M
authors.lastname: Salhan
keywords: CCM, cough and cold medication; CPM, chlorpheniramine; Cough and cold medication; DPH, diphenhydramine; DXT, dextromethorphan; Efficacy; MI, multiple ingredients; OTC, over the counter; PE, phenylephrine; PG, post-graduate; PRZ, promethazine; PS, pseudoephedrine; SI, single ingredient; Toxicity; pt., patient