Recommendations Decreased for Cough, Cold Medicine in U.S.

There has been a decrease in recommendations for opioid-containing and nonopioid cough and cold medicines (CCM) in the United States, according to a research letter published online in JAMA Pediatrics.

Daniel B. Horton, M.D., from the Rutgers Robert Wood Johnson Medical School in New Brunswick, New Jersey, and colleagues used data from the National Ambulatory Medical Care Surveys for 2002 to 2015 and the National Hospital Ambulatory Medical Care Surveys for 2002 to 2015 to examine physicians' recommendations for CCM, subclassified by the presence of opioid ingredients. Age-specific temporal changes were examined for 2002 to 2008 versus 2009 to 2015 and were compared to antihistamines in the U.S. pediatric population.

The researchers found that U.S. physicians ordered about 95.7 million CCM in a sample representing 3.1 billion pediatric visits during 14 years; of these CCM, 12 percent contained opioids. There were substantial decreases in recommendations for opioid-containing and nonopioid CCM; recommendations for antihistamines increased. Compared with older children, the trend in recommendations for nonopioid CCM and opioid-containing CCM declined more strongly in children younger than 2 years and younger than 6 years, respectively, after 2008.

"Our findings are consistent with reported decreases in unintentional pediatric CCM ingestions and associated adverse events after 2008," the authors write. "Future work should investigate more recent trends in CCM use and related outcomes in pediatric populations."

Two authors disclosed financial ties to the pharmaceutical industry.

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