A study published recently in Pediatrics found that one in 20 children were prescribed codeine after having a tonsillectomy and/or adenoidectomy at the end of 2015, despite a black box warning issued by the Food and Drug Administration (FDA) in 2013 regarding safety and efficacy issues associated with prescribing the opioid to children after these surgeries.
The study authors, led by Kao-Ping Chua, MD, PhD, a pediatrician at the University of Chicago, analyzed 362,992 privately insured children who underwent tonsillectomy and/or adenoidectomy between 2010 and 2015. Using an interrupted time series design, the researchers estimated level and slope changes in the proportion of children with one or more prescription fills for codeine and one or more fills for an alternative opioid, such as hydrocodone, within seven days of surgery.
The researchers found a 13.3% drop in the proportion of children with one or more prescription fills for codeine after tonsillectomy and/or adenoidectomy following the 2013 FDA warning. However, the warning did not did not completely eliminate the practice. The investigators found that 5.1% of these children still had at least one prescription filled for the medication in December 2015, three years following the black box warning.
The authors conclude that there is still a need to eliminate inappropriate codeine prescribing and encourage the use of effective non-opioid medications such as ibuprofen following these surgeries.