2002 Pediatrics

The Year in Review

2002 doesn't look like it is going to be a very big year for Pediatrics. There were some advances, but nothing very exciting, like a new cure for asthma would be, or an easy way to prevent or treat the common cold.

One advance was the introduction of infant formulas with DHA and ARA, which may aid your baby's development. In addition to Enfamil LIPIL and Similac Advance, which were introduced early in 2002, premature infant formulas (Enfamil EnfaCare LIPIL and Neosure Advance) and soy formulas (Enfamil ProSobee LIPIL and Isomil Advance) with DHA and ARA are now available.

And immunizations had a prominent place in Pediatric news this past year, with the removal of thimerosal from vaccines and the big immunization shortages that caused some children to get behind. Fortunately, most shortages have been resolved, and with thimerosal free vaccines and recent reports that showed no connection between vaccines and autism, children will hopefully get back on track and up-to-date on their immunizations.

Even more exciting is the news that a new 'super' vaccine will soon be available. Pediarix is a new vaccine that combines DTaP, Hepatitis B, and IPV (polio) into one immunization, so that your child can get fewer shots at each visit to the doctor.

As in other recent years, 2002 had some new medications for ADHD. In addition to Ritalin LA, another long acting, once a day form of Ritalin, and Focalin, new strengths were introduced for Concerta (18, 27, 36, and 54mg) and Adderall XR (5, 10, 15, 20, 25, and 30mg), making stimulant dosing more flexible. Also, a new non-stimulant medication, Strattera, was FDA approved and should be available early in 2003.

The treatment of allergies made the news too, with the switch of Claritin from prescription to over-the-counter status. The high cost of OTC Claritin makes this less than welcome news for most parents who previously just paid a copay for prescription Claritin. Also introduced this year is Clarinex, a new prescription strength form of Claritin, which is available as a pill for kids over age 12.

Other allergy medications, like Zyrtec and Nasonex were approved for use in younger children. Zyrtec can now be used in children as young as 6 months of age and Nasonex beginning at age 2 years. These medications were already widely used by Pediatricians 'off label' in younger kids already, so the new official indications didn't make that big a difference in how we practice medicine.

Although not a new antibiotic, Zithromax was approved to be used in a larger, one time dose for ear infections. This is welcome news for parents who have a hard time getting their kids to take medicine.

Other Pediatric announcements in 2002 include the use of:

• Lactobacillus to treat kids with diarrhea.
• preventative steroids in children with persistent asthma symptoms (updated asthma treatment guidelines).
• a needle-free, wristwatch size device (Glucowatch) to measure glucose levels in children over age 7 years with diabetes.
• a nonsteroidal cream, Elidel, for kids with eczema.
• direct fluorescent assay (DFA) tests from nasal swabs for respiratory syncytial virus, influenza A and B, parainfluenza viruses 1, 2, and 3, and adenovirus. Rapid testing for viral infections can help cut down on unnecessary hospitalizations and the overuse of antibiotics. It will be really nice once they tests become cheaper and easier to use so that your Pediatrician can do them in their office. That way we will have some proof when we say 'it is just a virus.'
• LATCH (Lower Anchors and Tethers for Children), a new standardized child safety seat system that will simplify child safety seat installation and enhance child safety.
• a new nationwide, toll-free number to reach your local poison control center (1-800-222-1222).
• duct tape to remove warts in children.

In The News

Although prominent in the news and many parents were worried about it, fortunately, the West Nile Virus didn't seem to affect children very much.

Bioterrorism was also in the news a lot, and parents will have to decide about the risks and benefits of the small pox vaccine for their children once it becomes more widely available in 2004.

The Future of Pediatrics

Are there any new and exciting developments in the near future of Pediatrics?

I did read about a Ritalin patch for kids with ADHD, but it is hard to think that it will be much better than the once a day pills that are already available.

And Flumist, a nasal spray flu vaccine was recently FDA approved and should be ready for next year's flu season. Although it is great that older children and adults will be able to get a flu vaccine without a shot, the only downside is that is was only approved for children over age 5 years. Reports of an increase in asthma in children under age 5 that received the vaccine means that it won't be available for younger children.

Although not new medications, you can look to see more generic versions of popular medicines next year, including Augmentin, Claritin and Suprax (cefixime).