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

IF 2.9 3区医学 Q2 PHARMACOLOGY & PHARMACY

Clinical Drug Investigation Pub Date : 2025-05-28 DOI:10.1007/s40261-025-01444-9

Sara Karami, Christian Angelo I Ventura, Ellen Pinnow, Jody Green, Ajoa Asonye, Ibrahim T Ibrahim, Lynda McCulley, Gerald J Dal Pan, Esther H Zhou

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引用次数: 0

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic dramatically impacted healthcare systems.

Objective: We assessed monthly unintentional pediatric (< 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.

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COVID-19大流行期间美国儿童非处方感冒、咳嗽、镇痛和解热药物暴露病例的趋势

背景：2019冠状病毒病（COVID-19）大流行严重影响了医疗保健系统。目的：我们使用国家毒药数据系统（提取于2023年8月），评估COVID-19大流行之前和期间，涉及选定的非处方感冒和咳嗽（CC）以及镇痛和解热（AA）药物的每月意外儿科（< 18岁）暴露病例率趋势。方法：纳入右美沙芬、愈创甘油醚、苯肾上腺素、伪麻黄碱等CC类药物，对乙酰氨基酚、萘普生、布洛芬、乙酰水杨酸等AA类药物；他汀类药物作为对照。我们进行了描述性分析，包括单一产品意外暴露的儿科病例，按性别和年龄分列。我们进行了中断时间序列（ITS）分析，模拟了大流行的直接影响和持续影响之间的关联，并根据人口和季节性进行了调整。结果：总体而言，除对照、乙酰水杨酸和萘普生药物外，每月意外单一产品暴露的病例率在大流行开始时急剧下降。在ITS分析中，涉及6岁以下儿童的病例发生率下降最为显著，在大流行开始时，非故意一般和非故意治疗错误的发生率在统计上显著下降，每百万人口下降1.8-12.6例。在大流行期间，病例率在1.5年内逐渐上升到大流行前的水平。对于涉及6岁以下儿童的病例，与大流行前的水平相比，这些接触病例率在统计上显著上升，每月每百万人中增加0.1-0.6例。6-12岁病例的月发病率模式与6岁以下病例的月发病率模式一致，但水平和趋势变化不太明显。结论：这些发现强调需要不断调整公共卫生战略，以确保在长时间的突发公共卫生事件期间的药物安全。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Drug Investigation 医学-药学

CiteScore

5.90

自引率

3.10%

发文量

108

审稿时长

6-12 weeks

期刊介绍： Clinical Drug Investigation provides rapid publication of original research covering all phases of clinical drug development and therapeutic use of drugs. The Journal includes: -Clinical trials, outcomes research, clinical pharmacoeconomic studies and pharmacoepidemiology studies with a strong link to optimum prescribing practice for a drug or group of drugs. -Clinical pharmacodynamic and clinical pharmacokinetic studies with a strong link to clinical practice. -Pharmacodynamic and pharmacokinetic studies in healthy volunteers in which significant implications for clinical prescribing are discussed. -Studies focusing on the application of drug delivery technology in healthcare. -Short communications and case study reports that meet the above criteria will also be considered. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in Clinical Drug Investigation may be accompanied by plain language summaries to assist readers who have some knowledge, but non in-depth expertise in, the area to understand important medical advances.