Emergency Hospitalizations for Unsupervised PrescriptionMedicationIngestionsbyYoungChildren

abstract BACKGROUND:Emergencydepartmentvisitsandsubsequenthospitaliza-tionsofyoungchildrenafterunsupervisedingestionsofprescriptionmed-ications are increasing despite widespread use of child-resistantpackaging and caregiver education efforts. Data on the medicationsimplicated in ingestions are limited but could help identify preventionpriorities and intervention strategies.METHODS: We used nationally representative adverse drug event datafrom the National Electronic Injury Surveillance System–Cooperative Ad-verse Drug Event Surveillance project and national retail pharmacy pre-scription data from IMS Health to estimate the frequency and rates ofemergency hospitalizations for unsupervised prescription medicationingestions by young children (2007–2011).RESULTS: On the basis of 1513 surveillance cases, 9490 estimated emergencyhospitalizations (95% con fidence interval: 6420–12560) occurred annually in theUnited States for unsupervised prescript ion medication ingestions among chil-dren aged ,6 years from 2007 through 2011; 75.4% involved 1- or 2-year oldchildren. Opioids (17.6%) and benzodia zepines (10.1%) were the most commonlyimplicated medication classes. The most c ommonlyimplicatedactiveingredientswere buprenorphine (7.7%) and clonidine (7.4%). The top 12 active ingredients,alone or in combination with others, wer e implicated in nearly half (45.0%) ofhospitalizations. Accounting for the number of unique patients who receiveddispensed prescriptions, the hospitalization rate for unsupervised ingestion ofbuprenorphine products was signifi cantly higher than rates for all other com-monly implicated medications and 97-fold higher than the rate for oxycodoneproducts (200.1 vs 2.1 hospitaliz ations per 100000 unique patients).CONCLUSIONS: Focusing unsupervised ingestion prevention efforts onmedications with the highest hospitalization rates may efficiently achievelarge public health impact. Pediatrics 2014;134:e1009–e1016