Despite its potentially harmful effects in children, codeine continues to be prescribed in U.S. emergency rooms, according to new research from UCSF Benioff Children's Hospital San Francisco.
As reported in the May issue of Pediatrics, solutions include changing provider prescription behaviors to promote the use of better alternatives to codeine, such as ibuprofen or hydrocodone.
"Despite strong evidence against the use of codeine in children, the drug continues to be prescribed to large numbers of them each year," said Sunitha Kaiser, MD, UCSF assistant clinical professor of pediatrics at UCSF Benioff Children's Hospital San Francisco and lead author. "It can be prescribed in any clinical setting, so it is important to decrease codeine prescription to children in other settings such as clinics and hospitals, in addition to emergency rooms."
Codeine is an opioid used to treat mild to moderate pain and suppress cough. Because of variability in how children process the drug, about a third receive no symptom relief from taking it, while up to one in 12 can accumulate toxic amounts causing breathing to slow down and possible death.
As a result, several national and international organizations advise against codeine use in children. Guidelines from the American Academy of Pediatrics (AAP) issued in 1997 and reaffirmed in 2006 warn of its potential dangers and lack of documented effectiveness in children with coughs and colds, and the American College of Chest Physicians 2006 guideline on treatment of pediatric cough also advises against the drug.
Until now it was unknown to what extent codeine was being prescribed to children in US emergency rooms, where it can be prescribed for common complaints such as painful injuries and coughs and colds.
To gain insight, Kaiser and her colleagues used the National Hospital and Ambulatory Medical Care Survey, done by the National Center for Health Statistics, to dete
|Contact: Juliana Bunim|
University of California - San Francisco