{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T06:19:09Z","timestamp":1790230749551,"version":"4.1.0"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T00:00:00Z","timestamp":1748390400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T00:00:00Z","timestamp":1748390400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100006225","name":"Oak Ridge Associated Universities","doi-asserted-by":"publisher","award":["DE-SC0014664"],"award-info":[{"award-number":["DE-SC0014664"]}],"id":[{"id":"10.13039\/100006225","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Drug Investig"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>The coronavirus disease 2019 (COVID-19) pandemic dramatically impacted healthcare systems.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Objective<\/jats:title>\n            <jats:p>We assessed monthly unintentional pediatric (&lt; 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).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>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\u2019s immediate and sustained effects, adjusting for population and seasonality.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Overall, apart from the control, acetylsalicylic acid, and naproxen drugs, monthly unintentional single-product exposure case rates decreased sharply at the pandemic\u2019s onset. In ITS analyses, rates decreased most notably for cases involving children &lt; 6 years old, where unintentional-general and unintentional-therapeutic error case rates statistically significantly fell by 1.8\u201312.6 cases per million population at the pandemic\u2019s onset. During the pandemic, case rates gradually increased to pre-pandemic levels within 1.5 years. For cases involving children &lt; 6 years old, these exposure case rates statistically\u00a0significantly rose by 0.1\u20130.6 cases per million population per month compared with pre-pandemic levels. Monthly case rate patterns for cases 6\u201312 years old mirrored those of cases &lt; 6 years old, with less pronounced level and trend changes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>These findings underscore the need for continuously adapting public health strategies to ensure drug safety during prolonged periods of public health emergencies.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s40261-025-01444-9","type":"journal-article","created":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T03:18:20Z","timestamp":1748402300000},"page":"401-416","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Trends in US Pediatric Unintentional Nonprescription Cold and Cough, Analgesic and Antipyretic Drug Exposure Cases amid the COVID-19 Pandemic"],"prefix":"10.1007","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7658-7977","authenticated-orcid":false,"given":"Sara","family":"Karami","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian Angelo I.","family":"Ventura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9183-4662","authenticated-orcid":false,"given":"Ellen","family":"Pinnow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jody","family":"Green","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajoa","family":"Asonye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim T.","family":"Ibrahim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0935-3876","authenticated-orcid":false,"given":"Lynda","family":"McCulley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4874-5864","authenticated-orcid":false,"given":"Gerald J","family":"Dal Pan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4608-6850","authenticated-orcid":false,"given":"Esther H.","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,28]]},"reference":[{"key":"1444_CR1","unstructured":"Janet Nguyen. 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This research was supported in part by an appointment to a Research Participation Program administered by the Oak Ridge Institute for Science and Education (ORISE) through an interagency agreement between the US Department of Energy and the US Food and Drug Administration. ORISE is managed by Oak Ridge Associated Universities under DOE contract number DE-SC0014664. The views in this article are those of the authors and not necessarily those of the US Food and Drug Administration.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Funding"}},{"value":"The authors report no potential conflicts of interest, financial or otherwise. The views in this manuscript are those of the authors and not necessarily those of the US Food and Drug Administration (FDA).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was classified as a public health surveillance activity by the US FDA Institutional Review Board.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Not applicable.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Not applicable.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Not applicable.","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Code availability"}},{"value":"Not applicable. Please see the data source below: America\u2019s Poison Centers maintains the National Poison Data System (NPDS), which houses de-identified records of self-reported information from callers to the country\u2019s poison centers (PCs). NPDS data do not reflect the entire universe of US exposures and incidences related to any substance(s). Exposures do not necessarily represent a poisoning or overdose and America\u2019s Poison Centers are not able to completely verify the accuracy of every report. The views of this article are those of the authors and do not necessarily reflect the opinions of America\u2019s Poison Centers.","order":8,"name":"Ethics","group":{"name":"EthicsHeading","label":"Data availability"}},{"value":"All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Sara Karami, Esther H. Zhou, and Ibrahim Ibrahim. The first draft of the manuscript was written by Sara Karami and Christian Angelo I. Ventura, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.","order":9,"name":"Ethics","group":{"name":"EthicsHeading","label":"Author contributions"}}]}}