Codeine Still Prescribed for Kids in the ER

By Kelly Young

Children presenting to U.S. emergency departments with cold and upper respiratory infections are still receiving prescriptions for codeine, despite guidelines recommending against this practice, according to a Pediatrics study.

Researchers analyzed data from 56,000 children (aged 3 to 17 years) seeking care in emergency departments from 2001 to 2010.

Although the proportion of visits in which codeine was prescribed for any cause decreased from 3.7% to 2.9% over 10 years, prescriptions for cough and upper respiratory infections didn't significantly change after 2006, when guidelines from several medical societies recommended against codeine's use for this indication.

Both the authors and editorialists recommend that hospital formularies remove codeine. The editorialists conclude: "There may be reasons why clinicians are still attached to the use of codeine in everyday practice; and they will howl with dismay when it is gone. But we must find novel ways to convince them that there is a need to change and that the time to retire this drug is today."