Adherence to Federal Opioid Prescribing Guidelines in Children's Surgery

jpedsurg.org

Despite increased awareness of the potential harms of prescription opioid use, a need remains for effective opioid stewardship within pediatric surgery [1]. The Food and Drug Administration (FDA) has provided national guidance to inform safe opioid prescribing for children, including a contraindication to prescribing codeine or tramadol in children under 12 years and a warning against prescribing codeine or tramadol in adolescents with pulmonary comorbidities [2]. Monitoring hospital-level adherence to this guidance has been limited to retrospective observational studies, which estimate prescribing practices based on administrative and pharmaceutical data [3,4].

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Article · Mar 2025 · 1 min read

In brief

This article examines hospital adherence to FDA opioid prescribing guidelines in pediatric surgical patients, focusing on contraindications for codeine and tramadol in children under 12 and adolescents with pulmonary conditions. Current monitoring relies on retrospective data, highlighting gaps in real-time opioid stewardship practices.

FDA contraindicates codeine and tramadol in children under 12 years due to safety concerns.
Codeine and tramadol carry warnings for adolescents with pulmonary comorbidities.
Hospital adherence to pediatric opioid guidelines is primarily assessed through retrospective data review.
Effective opioid stewardship remains a critical need in pediatric surgical practice.
Current monitoring methods rely on administrative and pharmaceutical databases rather than prospective tracking.

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