Trends in US Pediatric Unintentional Nonprescription Cold and Cough, Analgesic and Antipyretic Drug Exposure Cases amid the COVID-19 Pandemic

Publications Category : Epidemiology

Author(s): Christian Angelo Ventura, Sara Karami, Ellen Pinnow, Jody Green, Ajoa Asonye, Ibrahim T. Ibrahim, Lynda McCulley, Gerald J Dal Pan, Esther H. Zhou

Project Description : We assessed monthly unintentional pediatric (less than 18 years) exposure case rate trends involving selected nonprescription cold and cough (CC), as well as analgesic and antipyretic (AA) drugs, before and during the COVID-19 pandemic, using the National Poison Data System (extracted August 2023). Methods We included dextromethorphan, guaifenesin, phenylephrine, and pseudoephedrine CC drugs, and acetaminophen, naproxen, ibuprofen, and acetylsalicylic acid AA drugs; statins served as a control. We performed descriptive analyses involving single-product unintentional pediatric exposure cases overall, by sex, and by age. We performed interrupted time series (ITS) analyses, modeling associations between the pandemic’s immediate and sustained effects, adjusting for population and seasonality. Results Overall, apart from the control, acetylsalicylic acid, and naproxen drugs, monthly unintentional single-product exposure case rates decreased sharply at the pandemic’s onset. In ITS analyses, rates decreased most notably for cases involving children < 6 years old, where unintentional-general and unintentional-therapeutic error case rates statistically significantly fell by 1.8–12.6 cases per million population at the pandemic’s onset. During the pandemic, case rates gradually increased to pre-pandemic levels within 1.5 years. For cases involving children < 6 years old, these exposure case rates statistically significantly rose by 0.1–0.6 cases per million population per month compared with pre-pandemic levels. Monthly case rate patterns for cases 6–12 years old mirrored those of cases < 6 years old, with less pronounced level and trend changes. Conclusions These findings underscore the need for continuously adapting public health strategies to ensure drug safety during prolonged periods of public health emergencies.