{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T17:09:19Z","timestamp":1788196159689,"version":"build-2803163510"},"reference-count":25,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,11,1]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>BACKGROUND AND OBJECTIVES<\/jats:title>\n                    <jats:p>In 2008, over-the-counter cough and cold medications (CCMs) underwent labeling changes in response to safety concerns, including fatalities, reported in children exposed to CCMs. The objective of this study is to describe fatalities associated with exposures to CCMs in children &amp;lt;12 years old that were detected by a safety surveillance system from 2008 to 2016.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Fatalities in children &amp;lt;12 years old that occurred between 2008 and 2016 associated with oral exposure to one or more CCMs were identified by the Pediatric Cough and Cold Safety Surveillance System. An expert panel reviewed all cases to determine the causal relationship between the exposure and death, if the intent of exposure was therapeutic, and if the dose was supratherapeutic. Other contributing factors related to the child\u2019s death were also identified as part of a root cause analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Of the 180 eligible fatalities captured during the study period, 40 were judged by the expert panel to be either related or potentially related to the CCM. Of these, the majority (n = 24; 60.0%) occurred in children &amp;lt;2 years old and involved nontherapeutic intent (n = 22; 55.0%). The most frequently involved index ingredient was diphenhydramine (n = 28; 70.0%). In 6 cases (n = 6; 15.0%), the CCM was administered to murder the child. In another 7 cases (n = 7; 17.5%), death followed the intentional use of the CCM to sedate the child.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Pediatric fatalities associated with CCMs occurred primarily in young children after deliberate medication administration with nontherapeutic intent by a caregiver.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.2020-049536","type":"journal-article","created":{"date-parts":[[2021,10,4]],"date-time":"2021-10-04T09:51:01Z","timestamp":1633341061000},"source":"Crossref","is-referenced-by-count":28,"title":["Pediatric Fatalities Associated With Over-the-Counter Cough and Cold Medications"],"prefix":"10.1542","volume":"148","author":[{"given":"Laurie Seidel","family":"Halmo","sequence":"first","affiliation":[{"name":"aDepartment of Pediatrics, Children\u2019s Hospital Colorado and University of Colorado Anschutz Medical Campus, Aurora, Colorado;"},{"name":"bRocky Mountain Poison and Drug Safety, Denver Health and Hospital Authority, Denver, Colorado;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George Sam","family":"Wang","sequence":"additional","affiliation":[{"name":"aDepartment of Pediatrics, Children\u2019s Hospital Colorado and University of Colorado Anschutz Medical Campus, Aurora, Colorado;"},{"name":"bRocky Mountain Poison and Drug Safety, Denver Health and Hospital Authority, Denver, Colorado;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate M.","family":"Reynolds","sequence":"additional","affiliation":[{"name":"bRocky Mountain Poison and Drug Safety, Denver Health and Hospital Authority, Denver, Colorado;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Delva-Clark","sequence":"additional","affiliation":[{"name":"bRocky Mountain Poison and Drug Safety, Denver Health and Hospital Authority, Denver, Colorado;"},{"name":"cCPC Clinical Research, Aurora, Colorado;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malin","family":"Rapp-Olsson","sequence":"additional","affiliation":[{"name":"bRocky Mountain Poison and Drug Safety, Denver Health and Hospital Authority, Denver, Colorado;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Banner","sequence":"additional","affiliation":[{"name":"dOklahoma Center for Poison and Drug Information and College of Pharmacy, The University of Oklahoma Health Sciences Center, The University of Oklahoma, Oklahoma City, Oklahoma;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. Randall","family":"Bond","sequence":"additional","affiliation":[{"name":"eFacult\u00e9 de M\u00e9decine, Hope Africa University, Bujumbura, Burundi;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph E.","family":"Kauffman","sequence":"additional","affiliation":[{"name":"fDepartment of Pediatrics, School of Medicine, University of Missouri-Kansas City, Kansas City, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert B.","family":"Palmer","sequence":"additional","affiliation":[{"name":"bRocky Mountain Poison and Drug Safety, Denver Health and Hospital Authority, Denver, Colorado;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian M.","family":"Paul","sequence":"additional","affiliation":[{"name":"gDepartments of Pediatrics and Public Health Sciences, College of Medicine, The Pennsylvania State University, Hershey, Pennsylvania; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jody L.","family":"Green","sequence":"additional","affiliation":[{"name":"bRocky Mountain Poison and Drug Safety, Denver Health and Hospital Authority, Denver, Colorado;"},{"name":"hInflexxion, Costa Mesa, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard C.","family":"Dart","sequence":"additional","affiliation":[{"name":"bRocky Mountain Poison and Drug Safety, Denver Health and Hospital Authority, Denver, Colorado;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2021,11,1]]},"reference":[{"key":"2022081818521787200_B1","unstructured":"C.S. 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