Choosing Wisely:

Cough and cold medicines should not be prescribed or recommended for respiratory illnesses in children younger than four years.

Rationale and Comments: Research has shown these products offer little benefit to young children, and can have potentially serious side effects. Many cough and cold products for children have more than one ingredient, increasing the chance of accidental overdose if combined with another product.
Sponsoring Organizations:
  • American Academy of Pediatrics
  • Sources:
  • American College of Chest Physicians guidelines
  • Disciplines:
  • Pediatric
  • References: • Carr BC. Efficacy, abuse, and toxicity of over-the-counter cough and cold medications in the pediatric population. Curr Opin Pediatr. 2006;18(2):184-8.
    • Irwin RS, et al. Diagnosis and management of cough executive summary: ACCP evidence-based clinical practice guidelines. Chest. 2006;129(1 suppl):1S-23S.
    • Isbister GK, et al. Restricting cough and cold medications in children. J Paediatr Child Health. 2012;48(2):91-8.
    • Schaeffer MK, et al. Adverse events from cough and cold medication in children. Pediatrics. 2008;121(4):783-82.
    • Sharfstein JM, et al. Over the counter but no longer under the radar–pediatric cough and cold medications. N Engl J Med. 2007;357(23):2321-4.

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