Survey helps discern characteristics of pediatric medication use

More than half of a nationally representative sample of U.S. children aged younger than 12 years use one or more medications within a given week, according to data from the Slone Survey, a random-digit-dial telephone survey.

“The most commonly consumed active ingredients (excluding vitamins) were acetaminophen, iron, ibuprofen and various cough/cold ingredients (pseudoephedrine, dextromethorphan and various first-generation antihistamines,” Vernacchio et al wrote.

Acetaminophen, ibuprofen and multivitamins were at the top of the list, with over-the-counter formulations outnumbering prescription usage two-to-one among the 2,857 respondents enrolled. However, prevalence varied depending on the child’s age — with acetaminophen use peaking at 23% among children aged older than 24 months and multivitamin use at 24% among children aged 2 to 5 years. Ibuprofen usage was about 7% across all age groups.

“As recent reports regarding adverse events associated with pediatric cough/cold medications have demonstrated, understanding the usage patterns and inherent risks of exposure to readily-available OTC medications is important for safeguarding the health of children,” the researchers wrote.

Twenty-percent of the children surveyed had used one or more prescription medication in the week prior to completing the survey — with amoxicillin, albuterol and multivitamins with fluoride among the most common. However, less than 6% used two or more prescription-only drugs within a given week.

The number of medications and prevalence of use among the study population were as follows:

Two medications; 15%.
Three medications; 7.1%.
Four medications; 3.1%
Five or more medications; 1.9%.

“Given this large amount of medication exposure, it is essential to continue to monitor the use of medications by children as part of ongoing efforts to ensure the safety of these products,” the researchers wrote.

Another trend the researchers noted was alternating between acetaminophen and ibuprofen for treating young febrile children within the same week. “Although the safety for children of each of these medications alone is well established, the question of whether concomitant use increases the risk of adverse events has not been carefully studied,” the researchers wrote.

Medication usage patterns may vary between actual respondents, nonresponders and subsets of underrepresented Southern children, the researchers warned, as the sample of participants was weighted more towards families in the Western United States who were better educated.

Vernacchio L et al. Pediatrics 2009;doi:10.1542/peds.2008-2869.