Avoid Decongestants for Colds in Under Age 6 Children

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Decongestants should not be given to children younger than age 6 years and should be given with caution in those younger than age 12 years, experts conclude in a review published online in BMJ.

No Evidence of Benefit in Children
In their review, van Driel and colleagues evaluated the evidence for various OTC items intended to relieve the symptoms of common upper respiratory infections.

For adults, they evaluated Cochrane reviews that covered treatments such as decongestants, antihistamines, analgesics, intranasal corticosteroids, herbal remedies, and vitamins and minerals (zinc) for the common cold. One review showed sedating antihistamines were associated with relief of rhinorrhea and sneezing versus placebo, but not nasal congestion, and sedation were commonly reported.

The effects of nonsedating antihistamines in adults were unclear, and there was no effect noted for rhinorrhea or sneezing. There was also no increase in the risk of adverse events in adults compared with placebo.

For young children, though, the situation is more problematic because clinical trial data are lacking. Children younger than age 12 years have the highest burden of common colds, and van Driel and coauthors emphasize that the efficacy and safety data are unavailable for this population.

One Cochrane review found low-quality evidence that saline irrigations or drops may be effective and safe in young children, while several small trials have reported contradictory results for the use of decongestants and antihistamines on nasal symptoms and safety in children. Although some products that contain decongestant may improve nasal symptoms in children, safety is unclear, especially in small children.

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https://www.medscape.com/viewarticle/90 ... ants&faf=1