A retrospective study on the usage of cough and cold medications in viral respiratory tract infections in Taiwanese children

Objective: We sought to describe the epidemiology of viral respiratory-tract infections and patterns in prescriptions of cough and cold medications among young children who were suffering from viral respiratory tract infections (vRTIs).

Methods: We conducted a cross-sectional study to examine vRTI-episode occurrence and cold-medication utilization in outpatients in 2007 using the National Health Insurance Research Database (NHIRD) in Taiwan. One-third of the children under 12 years of age who had at least one outpatient visit for a vRTI as randomly selected from NHIRD were included in the analysis.

Results: A total of 895,942 children had a diagnosis of vRTI (6,144,336 visits) during 2007, 58% of whom were aged 6 to 12 years, and 52% of whom were male. The mean cumulative incidence of vRTIs by ages were 5.6 in infancy, 7.1 in preschool, and 4.0 in school children. The average number of cough and cold medications without other drugs prescribed per visit was two to three. Among cough and cold medications, antihistamines for systemic use were prescribed most frequently (20%), followed by mucolytics (12%), selective beta-2 agonists (11%), decongestants for systemic use (10%), and analgesic-antipyretics including acetaminophen (7%) or non-steroid anti-inflammatory drugs (6%). There was considerable variation of prescriptions, which increased with increasing age, where the top 20 prescription accounted for only 36%, 30%, and 25% of all prescriptions in infants, preschool, and school age children, respectively.

Conclusions: A more rational use of medicines for treatment of vRTIs in children in Taiwan needs to be developed.