Document Detail

Unexpected infant deaths associated with use of cough and cold medications.
MedLine Citation:
PMID:  18676517     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The objective of this study was to determine whether caregivers had given infants who died unexpectedly over-the-counter cough and cold medications before the infant deaths to identify sociodemographic risk factors for their use. METHODS: The Arizona Child Fatality Review Program reviews the circumstances surrounding every child death that occurs in the state each year. By statute, the multidisciplinary review teams have access to all medical charts, autopsy reports, law enforcement reports, and other records for their review and use these data to determine the cause of death and its preventability. The data on all infants who died unexpectedly in 2006 and had an autopsy and postmortem toxicologic studies were reviewed for this analysis. RESULTS: Ten unexpected infant deaths that were associated with cold-medication use were identified. The infants ranged in age from 17 days to 10 months. Postmortem toxicology testing found evidence of recent administration of pseudoephedrine, antihistamine, dextromethorphan, and/or other cold-medication ingredients in these infants. The families who used these medications were poor and publicly insured, and 50% of them had limited English proficiency. Only 4 of these infants had received medical care for their current illness before their death. The over-the-counter cough and cold medication had been prescribed by a clinician for only 1 of these infants. CONCLUSIONS: Review of these infants' deaths raises concern about the role of the over-the-counter cough and cold medications in these deaths. These findings support the recommendation that such medications not be given to infants. In addition, these findings suggest that warnings on these medications "to consult a clinician" before use are not being followed by parents. Educational campaigns to decrease the use of over-the-counter cough and cold medications in infants need to be increased.
Mary E Rimsza; Susan Newberry
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatrics     Volume:  122     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-08-04     Completed Date:  2008-08-22     Revised Date:  2009-03-05    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e318-22     Citation Subset:  AIM; IM    
Department of Pediatrics, University of Arizona College of Medicine, Tucson, Arizona, USA.
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MeSH Terms
Adverse Drug Reaction Reporting Systems
Cause of Death*
Common Cold / drug therapy
Cough / drug therapy
Death, Sudden / etiology*
Expectorants / adverse effects*
Nonprescription Drugs / adverse effects*,  contraindications,  metabolism
Risk Assessment
Sudden Infant Death / epidemiology
United States
United States Food and Drug Administration
Reg. No./Substance:
0/Expectorants; 0/Nonprescription Drugs
Comment In:
Pediatrics. 2008 Dec;122(6):1413; author reply 1413   [PMID:  19047270 ]
Pediatrics. 2009 Feb;123(2):e358-9;author reply e359   [PMID:  19171592 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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