CDC: Warning labels on cough, cold medicines curbed kids' ER visits

November 12, 2013

By Michelle Castillo /CBS News

Emphasis on warning parents about the dangers of over-the-counter cough and cold medicines may have led to fewer emergency room visits for kids.

A new Centers for Disease Control and Prevention (CDC) study published on Nov. 11 in Pediatrics showed that fewer kids went to the ER after manufactures added warning labels to the medicine bottles.

Medication manufacturers voluntarily recalled some cough and cold medications in October 2007 after increases in reports of emergency department (ED) visits and deaths among young children. In 2008, the medications were re-released with clear warnings that these medications should not be used in children under 4 years old.

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Researchers looked at a database that estimated the amount of adverse events, or side effects, reported in U.S. emergency rooms linked to cough and cold medications. They found there were 61,168 ER visits between 2004 and 2011 among children 12 years old and younger due to these drugs.

Before the recall, children 2 and under who came into an emergency department for a reaction due to cold or cough medication accounted for around 4 percent of all visits related to drugs. After the medicines were sold with the clear warning label, the number dropped to 2 percent.

Declines were also seen in the 2 to 3-year-olds, who made up 10 percent of all ED visits before 2007. After 2008, that number was only 7 percent.

Lead study author Dr. Lee Hampton, a medical officer with the CDC in Atlanta, Ga., told Reuters that the warning labels, as well as media attention and education campaigns about the dangers of cold and cough medicines, may have made parents more aware of the potential risks.

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Dr. Daniel Frattarelli, a former chairman of the committee on drugs at the American Academy of Pediatrics who was not involved in the study, told the New York Times that "the label is a very powerful tool for changing parent behavior."

However, there was no significant reduction in ED visits among children aged 4 to 11. In fact, among 4 and 5-year-olds, researchers observed a 0.9 percent increase between the period before and after the warning labels.

Frattarelli said the labels should be changed to warn kids aged 6 and under, due to the reported misuse among 4 and 5-year-olds.

"The label doesn't reflect the current evidence that these medications are ineffective for treating cough and cold symptoms in kids under 6," Frattarelli argued.

Hampton also pointed out that 64 percent of the kids under 2 who were in the ED for cold and cough medicine-related events had taken it when their caregivers were not watching. The number stayed about the same before and after the warning labels changed.

After the changes, 89 percent of the 2 to 3-year-old group had taken the medications when they weren't being watched.

"Progress has been made, but there is still a lot of work to do to reduce adverse events from cough and cold medications," Hampton said.

Safe Kids Worldwide, a non-profit group dedicated to protecting children against accidental injuries, estimates that kids get into the wrong medication about 500,000 times each year.

Dr. Bradley Berg, medical director of Round Rock Pediatrics at Scott and White Healthcare, in Texas who was not involved in the study, emphasized to HealthDay that younger kids may be at higher risk for accidentally taking the potentially dangerous medications.

"Over-the-counter medications may seem benign to the average person, but they can be dangerous, especially in small children. The highest number of unsupervised ingestions was in 2- to 3-year-olds. These are kids that are beginning to be mobile and may start climbing and getting into more. And, these medications are sweet and good-tasting. This is the age group that parents really need to be monitoring," he said.

Hampton said that cough and cold medication containers should be changed to limit the flow of the drugs, so children couldn't consume them as easily. He also emphasized safer medication handling and storage.

"The three main things is first don't give cough and cold medications to children less than four years old, keep medications up and out of sight and properly lock the caps on medication bottles," Hampton said

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