{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T17:17:22Z","timestamp":1780507042216,"version":"3.54.1"},"reference-count":38,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,10,1]]},"abstract":"<jats:sec>\n                  <jats:title>BACKGROUND:<\/jats:title>\n                  <jats:p>Emergency department visits and subsequent hospitalizations of young children after unsupervised ingestions of prescription medications are increasing despite widespread use of child-resistant packaging and caregiver education efforts. Data on the medications implicated in ingestions are limited but could help identify prevention priorities and intervention strategies.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>We used nationally representative adverse drug event data from the National Electronic Injury Surveillance System\u2013Cooperative Adverse Drug Event Surveillance project and national retail pharmacy prescription data from IMS Health to estimate the frequency and rates of emergency hospitalizations for unsupervised prescription medication ingestions by young children (2007\u20132011).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>On the basis of 1513 surveillance cases, 9490 estimated emergency hospitalizations (95% confidence interval: 6420\u201312\u2009560) occurred annually in the United States for unsupervised prescription medication ingestions among children aged &amp;lt;6 years from 2007 through 2011; 75.4% involved 1- or 2-year old children. Opioids (17.6%) and benzodiazepines (10.1%) were the most commonly implicated medication classes. The most commonly implicated active ingredients were buprenorphine (7.7%) and clonidine (7.4%). The top 12 active ingredients, alone or in combination with others, were implicated in nearly half (45.0%) of hospitalizations. Accounting for the number of unique patients who received dispensed prescriptions, the hospitalization rate for unsupervised ingestion of buprenorphine products was significantly higher than rates for all other commonly implicated medications and 97-fold higher than the rate for oxycodone products (200.1 vs 2.1 hospitalizations per 100\u2009000 unique patients).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>Focusing unsupervised ingestion prevention efforts on medications with the highest hospitalization rates may efficiently achieve large public health impact.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2014-0840","type":"journal-article","created":{"date-parts":[[2014,9,16]],"date-time":"2014-09-16T04:36:33Z","timestamp":1410842193000},"page":"e1009-e1016","source":"Crossref","is-referenced-by-count":68,"title":["Emergency Hospitalizations for Unsupervised Prescription Medication Ingestions by Young Children"],"prefix":"10.1542","volume":"134","author":[{"given":"Maribeth C.","family":"Lovegrove","sequence":"first","affiliation":[{"name":"Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Mathew","sequence":"additional","affiliation":[{"name":"Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Hampp","sequence":"additional","affiliation":[{"name":"Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Governale","sequence":"additional","affiliation":[{"name":"Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland; and"},{"name":"AstraZeneca, Patient Safety, Gaithersburg, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane K.","family":"Wysowski","sequence":"additional","affiliation":[{"name":"Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel S.","family":"Budnitz","sequence":"additional","affiliation":[{"name":"Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2014,10,1]]},"reference":[{"issue":"21","key":"2021120906523425500_B1","doi-asserted-by":"crossref","first-page":"1661","DOI":"10.1001\/jama.1996.03530450051032","article-title":"The safety effects of child-resistant packaging for oral prescription drugs: two decades of experience.","volume":"275","author":"Rodgers","year":"1996","journal-title":"JAMA"},{"key":"2021120906523425500_B2","volume-title":"Poison Prevention Packaging: A Guide for Healthcare Professionals","author":"US Consumer Product Safety Commission","year":"2005"},{"key":"2021120906523425500_B3"},{"issue":"10","key":"2021120906523425500_B4","doi-asserted-by":"crossref","first-page":"911","DOI":"10.3109\/15563650.2012.746424","article-title":"2011 Annual report of the American Association of Poison Control Centers\u2019 National Poison Data System (NPDS): 29th annual report.","volume":"50","author":"Bronstein","year":"2012","journal-title":"Clin Toxicol (Phila)"},{"issue":"10","key":"2021120906523425500_B5","doi-asserted-by":"crossref","first-page":"910","DOI":"10.3109\/15563650.2011.635149","article-title":"2010 Annual report of the American Association of Poison Control Centers\u2019 National Poison Data System (NPDS): 28th annual report.","volume":"49","author":"Bronstein","year":"2011","journal-title":"Clin Toxicol (Phila)"},{"key":"2021120906523425500_B6"},{"key":"2021120906523425500_B7"},{"key":"2021120906523425500_B8"},{"issue":"10","key":"2021120906523425500_B9","doi-asserted-by":"crossref","first-page":"930","DOI":"10.3109\/15563650.2013.855314","article-title":"New insights into root causes of pediatric accidental unsupervised ingestions of over-the-counter medications.","volume":"51","author":"Schoenewald","year":"2013","journal-title":"Clin Toxicol (Phila)"},{"issue":"5","key":"2021120906523425500_B10","first-page":"380","article-title":"Effectiveness of child-resistant packaging on toxin procurement in young poisoning victims.","volume":"38","author":"Lembersky","year":"1996","journal-title":"Vet Hum Toxicol"},{"issue":"7","key":"2021120906523425500_B11","doi-asserted-by":"crossref","first-page":"853","DOI":"10.2105\/AJPH.79.7.853","article-title":"Accidental ingestions of oral prescription drugs: a multicenter survey.","volume":"79","author":"Jacobson","year":"1989","journal-title":"Am J Public Health"},{"issue":"2","key":"2021120906523425500_B12","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1016\/j.jpeds.2011.09.020","article-title":"The last mile: taking the final steps in preventing pediatric pharmaceutical poisonings.","volume":"160","author":"Budnitz","year":"2012","journal-title":"J Pediatr"},{"issue":"3","key":"2021120906523425500_B13","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.amepre.2009.05.018","article-title":"Medication overdoses leading to emergency department visits among children.","volume":"37","author":"Schillie","year":"2009","journal-title":"Am J Prev Med"},{"issue":"10","key":"2021120906523425500_B14","doi-asserted-by":"crossref","first-page":"S96","DOI":"10.1097\/MLR.0b013e318041f737","article-title":"Evaluation and overview of the National Electronic Injury Surveillance System-Cooperative Adverse Drug Event Surveillance Project (NEISS-CADES).","volume":"45","author":"Jhung","year":"2007","journal-title":"Med Care"},{"issue":"15","key":"2021120906523425500_B15","doi-asserted-by":"crossref","first-page":"1858","DOI":"10.1001\/jama.296.15.1858","article-title":"National surveillance of emergency department visits for outpatient adverse drug events.","volume":"296","author":"Budnitz","year":"2006","journal-title":"JAMA"},{"key":"2021120906523425500_B16"},{"key":"2021120906523425500_B17"},{"key":"2021120906523425500_B18","author":"Schroeder"},{"key":"2021120906523425500_B19","volume-title":"Survey Sampling","author":"Kish","year":"1995"},{"key":"2021120906523425500_B20"},{"issue":"2","key":"2021120906523425500_B21","doi-asserted-by":"crossref","first-page":"123","DOI":"10.2165\/00148581-200406020-00005","article-title":"Medications that can be fatal for a toddler with one tablet or teaspoonful: a 2004 update.","volume":"6","author":"Bar-Oz","year":"2004","journal-title":"Paediatr Drugs"},{"issue":"4","key":"2021120906523425500_B22","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1016\/j.emc.2004.05.004","article-title":"Deadly pediatric poisons: nine common agents that kill at low doses.","volume":"22","author":"Michael","year":"2004","journal-title":"Emerg Med Clin North Am"},{"key":"2021120906523425500_B23","unstructured":"Poison Prevention Week Council. [PoisonPrevention.org Web site]. Available at: www.poisonprevention.org\/index.htm. Accessed March 18, 2014"},{"key":"2021120906523425500_B24","unstructured":"National Capital Poison Center. Quills up\u2014stay away! Available at: www.poison.org\/prevent\/preschool.asp. Accessed March 18, 2014"},{"issue":"1","key":"2021120906523425500_B25","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1542\/peds.2012-2978","article-title":"Adult prescription drug use and pediatric medication exposures and poisonings.","volume":"132","author":"Burghardt","year":"2013","journal-title":"Pediatrics"},{"issue":"1","key":"2021120906523425500_B26","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.jpeds.2013.08.038","article-title":"Unintentional pediatric exposures to central alpha-2 agonists reported to the National Poison Data System.","volume":"164","author":"Wang","year":"2014","journal-title":"J Pediatr"},{"key":"2021120906523425500_B27"},{"issue":"4","key":"2021120906523425500_B28","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1016\/j.annemergmed.2008.07.015","article-title":"The underrecognized toll of prescription opioid abuse on young children.","volume":"53","author":"Bailey","year":"2009","journal-title":"Ann Emerg Med"},{"issue":"49","key":"2021120906523425500_B29","first-page":"997","article-title":"Buprenorphine prescribing practices and exposures reported to a poison center\u2014Utah, 2002-2011.","volume":"61","author":"Centers for Disease Control and Prevention","year":"2012","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2021120906523425500_B30"},{"issue":"3","key":"2021120906523425500_B31","first-page":"56","article-title":"Emergency department visits and hospitalizations for buprenorphine ingestion by children\u2014United States, 2010-2011.","volume":"62","author":"Centers for Disease Control and Prevention","year":"2013","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2021120906523425500_B32"},{"key":"2021120906523425500_B33","unstructured":"Consumer Healthcare Products Association. OTC industry announces voluntary transition to one concentration of single-ingredient pediatric liquid acetaminophen medicines [press release]. Washington, DC: Consumer Healthcare Products Association; May 4, 2011. Available at: www.chpa.org\/05_04_11_PedAcet.aspx. Accessed March 18, 2014"},{"key":"2021120906523425500_B34","unstructured":"Institute for Safe Medication Practices. Simple packaging change can reduce Rx drug diversion. Available at: www.consumermedsafety.org\/medication-safety-articles\/item\/721-simple-packaging-change-can-reduce-rx-drug-diversion. Accessed May 24, 2014"},{"key":"2021120906523425500_B35","unstructured":"Reckitt Benckiser Pharmaceuticals. Reckitt Benckiser Pharmaceuticals Inc. to voluntarily discontinue the supply of suboxone tablets (buprenorphine and naloxone sublingual tablets [CIII]) [press release]. Reckitt Benckiser Pharmaceuticals, Inc; September 25, 2012. Available at: www.rb.com\/site\/rkbr\/templates\/mediainvestorsgeneral2.aspx?pageid=1328&&cc=gb. Accessed May 27, 2014"},{"key":"2021120906523425500_B36","unstructured":"Orexo AB. Orexo provides update on reimbursement and launch preparations for Zubsolv [press release]. Uppsala, Sweden: Orexo AB; September 5, 2013. Available at: www.orexo.com\/en\/Investor-Relations\/Press-releases\/?guid=803851. Accessed March 18, 2014"},{"key":"2021120906523425500_B37","unstructured":"Drugs@FDA. Silver Spring, MD: US Food and Drug Administration; 2014. Available at: www.accessdata.fda.gov\/scripts\/cder\/drugsatfda\/index.cfm. Accessed June 5, 2014"},{"key":"2021120906523425500_B38","unstructured":"US Food and Drug Administration. Currently approved shared system REMS. Available at: www.fda.gov\/drugs\/drugsafety\/postmarketdrugsafetyinformationforpatientsandproviders\/ucm111350.htm#Shared. Accessed March 18, 2014"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/134\/4\/e1009\/1100268\/peds_2014-0840.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/134\/4\/e1009\/1100268\/peds_2014-0840.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T01:11:55Z","timestamp":1639098715000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/134\/4\/e1009\/32991\/Emergency-Hospitalizations-for-Unsupervised"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,10,1]]},"references-count":38,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2014,10,1]]},"published-print":{"date-parts":[[2014,10,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2014-0840","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,10,1]]}}}