US Doctors Giving Fewer Cough, Cold Medicines
A new study suggests that American doctors are telling patients to take cough or cold medicines less often than they did a few years ago.
The study comes at a time when health experts say these treatments may be ineffective or have serious side effects, mainly in young children.
Recommendations against giving cough and cold medicines to young children have become increasingly common in the United States since 2008. That was the year when the Food and Drug Administration advised against giving "over-the-counter" cough and cold drugs to children under the age of 2. Over-the-counter medicines are sold directly to patients or caregivers without doctors' orders or prescriptions.
Soon after, drug manufacturers recommended against cough and cold drugs for boys and girls under the age of 4. The American Academy of Pediatrics advised against these drugs for kids under the age of 6.
Researchers wanted to see how these recommendations have influenced doctors' prescriptions to patients. So they looked at records representing 3.1 billion pediatric visits from 2002 to 2015. All of the patients were babies or children.
The researchers looked at doctors' prescriptions of drugs for treating coughs and colds. They considered drugs both with and without opioids and antihistamines. Opioids are a group of drugs meant to reduce pain. They are available legally by prescription. Doctors often recommend antihistamines to help people suffering from allergic reactions.
The researchers compared the years before 2008 to the years after 2008. They found a 70% drop in prescriptions for non-opioid cough and cold medicines for children under 2 years old. Recommendations for cough and cold drugs with opioids dropped by 90% among children under 6 years old.
Doctor Daniel Horton was lead author of a report on the study. He is a researcher at the Rutgers Robert Wood Johnson Medical School in New Jersey.
"Our study suggests that doctors responded to professional warnings against the use of cough and cold medicines in young children," he said.
Antihistamine recommendations for young children increased during the period, however.
"Given that many parents want some treatment, one might guess that some doctors started recommending antihistamines more often as a safer alternative to other cough and cold (medicines), even though there is little evidence that they actually work to treat colds in children," Horton said by email.
The study had limitations. One was that researchers lacked information about whether parents followed recommendations to take or avoid specific medicines. Parents also might have given kids drugs that were not recommended by doctors, the researchers noted. Their findings were published in JAMA Pediatrics.
Generally, colds in children do not need to be treated with medicines, and children will get better on their own, Horton said. He added that, "Children should see their doctors if they are not able to keep up with fluids, appear dehydrated or lethargic, have difficulty breathing, have fevers that persist for several days, or if there are other concerns."
I'm John Russell.
1. suffer from (因疾病或处于其他不利境地而)受苦，受难，受折磨；
I still suffer from catarrh and sinus problems.
2. respond to 应对；作出回应；作出反应；
The best way to re spond to a flame is to ignore it.
3. even though 即使；尽管；纵然；
Even though I'm quite a reserved person, I like meeting people.
4. on one's own 独立地；依靠自己地；
I work best on my own.
自2008年以来，不要给幼儿服用止咳药和感冒药的建议在美国越来越普遍 。那一年，美国食品药品监督管理局建议不要给2岁以下幼儿服用“不需处方便可出售的”止咳药和感冒药 。非处方药物可在不需医嘱或处方的情况下直接出售给患者或护理员 。
不久之后，药品制造商建议不要给4岁以下儿童服用止咳药和感冒药 。美国儿科学会建议6岁以下儿童不要服用这些药物 。
研究人员想知道这些建议对医生开给患者的处方产生了何种影响 。因此，他们查看了2002年至2015年的31亿次儿科门诊记录 。所有患者都是婴儿或儿童 。
研究人员查看了医生开出的治疗咳嗽和感冒的处方药 。他们考虑了药物包含和不包含阿片类物质和抗组胺剂的情况 。阿片类药物是旨在减少疼痛的一组药物 。这类药物可通过处方合法获得 。医生通常会建议用抗组胺药物来帮助出现过敏反应的患者 。
研究人员将2008年前后的记录进行了对比 。他们发现，为2岁以下儿童开出的非阿片类止咳和感冒药处方下降了70% 。而建议6岁以下儿童服用阿片类止咳药和感冒药的处方下降了90% 。
丹尼尔·霍顿医生是这份研究报告的首席作者 。他是新泽西州罗格斯大学罗伯特·伍德·约翰逊医学院的研究员 。
这项研究存在局限性 。其中一个局限是，在家长是否按照医嘱让孩子服用或避免特定药物方面，研究人员缺乏相关信息 。研究人员指出，父母也可能让孩子服用医生未推荐的药物 。他们的研究结果发表在《美国医学协会杂志—儿科学期刊》上 。
霍顿表示，一般来说，儿童感冒不必服用药物，他们可以自行痊愈 。他补充说：“如果儿童不能保持水分，出现脱水或昏睡、呼吸困难、发烧持续数天等症状，或存在其他担忧，那儿童应该去看医生 。”