In actively opposing the delivery of over-the-counter cough and cold medicines to young children, Janet Serwint is working to turn research evidence into health policy. “I’ve been interested in this issue for nearly 20 years,” says the Hopkins Children’s pediatrician. “These preparations are not effective and can cause needless harm.”

In December 2007, Serwint, with Baltimore City Health Commissioner Joshua Sharfstein and Johns Hopkins medical student Marisa North, published a paper (“Over the Counter but No Longer under the Radar — Pediatric Cough and Cold Medications”) in the New England Journal of Medicine (NEJM) opposing the use of these consumer medicines, culminating a whirlwind of regulatory activity they helped initiate early last year. Sharfstein and Serwint had, in the spring of 2007, told pediatric medical chiefs in the Baltimore region of their intention to petition the Food and Drug Administration (FDA) to warn the public that the medications were ineffective and potentially dangerous for infants and children younger than 6. The support in the medical community was immediate and resounding, says Serwint, and all the chiefs, including Hopkins Children’s Director George Dover, signed on.

By August of 2007, the FDA had issued a warning against parents giving the cough and cold medications. In October, the FDA said it would recommend against their use in children under 6, citing “the lack of evidence of efficacy and safety concerns.”

Serwint is a natural partner in such advocacy. Concerned for years by the injudicious use of these products, she and colleagues published confirming findings in a 2001 issue of Pediatrics. Every year since, approximately 900 Maryland children under the age of 5 have experienced reported overdoses; four deaths have been linked to them.

To teach future doctors how to turn their own research into policy to help patients, Serwint and colleagues have developed a community and advocacy rotation at Hopkins Children’s for its pediatric residents.