HealthDay News — Despite national guidelines recommending against pediatric use in 2006, some clinicians continue to prescribe codeine for pediatric cough or upper respiratory infection (URI), according to researchers.

“Although there was a small decline in codeine prescription over 10 years, use for cough or URI did not decline after national guidelines recommending against its use,” Sunitha V. Kaiser, MD, of the Hospital for Sick Children in Toronto, and colleagues reported in Pediatrics.

To assess changes in pediatric codeine prescribing rates, the researchers performed a serial cross-sectional analysis of ED visits in the United States from 2001 to 2010 among a nationally representative sample of patients aged 3 to 17 years who participated in the National Hospital Ambulatory Medical Care Survey.

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During the overall study period, the proportion of visits with codeine prescription decreased very little from 3.7% to 2.9% (P=0.008).

Rates of codeine prescription were higher for children aged 8 to 12 years (odds ratio 1.42; 95% CI: 1.21-1.67) and among clinicians outside the northeast, researchers found.

Rates of codeine prescription were lower for non-Hispanic black children (OR, 0.67; 95% CI: 0.56-0.8) and children with Medicaid (OR, 0.84; 95% CI: 0.71- 0.98).

“More effective interventions are needed to prevent prescription of this potentially hazardous drug to children,” the researchers wrote.


  1. Kaiser S et al. Pediatrics. 2014; doi: 10.1542/peds.2013-3171.