Acute Respiratory Infection

Are Antihistamines Replacing Cough and Cold Medications in Young Children?

Despite unclear benefits, off-label use of antihistamines in children with colds has increased in recent years. This increase is likely in response to a 2008 FDA public health advisory against the use of cough and cold medication in children under 2 years old and later recommendations from the American Academy of Pediatrics against use of these medications in children younger than 6 years of age.

For their study, the researchers examined data from national surveys including 3.1 billion pediatric clinic and emergency department visits from 2002 to 2015, specifically focusing on rates of recommendations for cough and cold medicines and antihistamines for acute respiratory infectious in children.

Following the 2008 FDA advisory, physician recommendations for non-opioid cough and cold medicines declined 56% in children under 2 years old and 68% for opioid-containing cough and cold medicines in children under 6 years. During the same period, rates of recommendations for antihistamines for children under 12 years increased by 25%.

—Michael Potts


Horton DB, Gerhard T, Strom BL. Trends in cough and cold medicine recommendations for children in the United States, 2002-2015 [published online July 29, 2019]. JAMA Pediatr. doi:10.1001/jamapediatrics.2019.2252.