One in 20 children continued to receive codeine after tonsil and adenoid surgery, despite a warning from FDA regulators two years prior, according a study published in Pediatrics.
The FDA issued a black box warning against using codeine after tonsil and adenoid surgery, due to the increase in reported number of patient deaths. Researchers investigated whether the black box warning had succeeded in eliminating codeine use in the aforementioned cases.
The research team analyzed a national sample of more than 300,000 privately insured children who had the surgeries between 2010 and 2015.
The study shows that while codeine prescriptions decreased after the black box warning, one in 20 children undergoing tonsil and adenoid surgeries were still prescribed codeine in December 2015.
"We should not prescribe codeine to children, for any reason," said Kao-Ping Chua, MD, PhD, lead author of the study and assistant professor of pediatrics and communicable diseases at Ann Arbor-based University of Michigan. "Some children rapidly convert codeine to morphine, resulting in a risk of overdose. Other children poorly metabolize codeine to morphine, resulting in no improvement in pain. Therefore, codeine is not just potentially unsafe, but also potentially ineffective."