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TABLE 3

Most Common Prescription Medication Combinations Used Among Children and Adolescents Concurrently Using Prescription Medications Overall and by Gender and Age Group in the United States (2009–2014)

Prevalence of Combinations, No. (%) [95% CI]
Overall, n = 9930–5 y6–12 y13–19 y
Girls (n = 112)Boys (n = 159)Girls (n = 156)Boys (n = 244)Girls (n = 170)Boys (n = 152)
Bronchodilators–respiratory inhalants 123 (10.5) [7.9–13.7] 12 (10.1) [5.1–19.3]a 21 (21.4) [13.0–33.1]* 24 (13.8) [6.6–26.6]a 38 (12.0) [8.1–17.4] 11 (3.5) [1.7–7.0]a 17 (9.2) [5.1–15.9]** 
Bronchodilators–leukotriene modifiers 99 (8.2) [6.3–10.4] 6 (4.6) [2.1–10.0]a 12 (6.6) [3.0–13.8]a 20 (8.9) [5.6–13.8] 36 (12.7) [8.4–18.6] 11 (6.6) [2.6–15.8]a 14 (6.7) [3.5–12.6]a 
Bronchodilators–adrenal cortical steroids 96 (6.9) [5.1–9.2] 24 (15.8) [10.1–23.9] 29 (13.8) [8.0–22.7] 14 (10.4) [4.6–21.8]a 18 (4.4) [2.7–7.2]** 6 (3.1) [1.1–8.3]a 5 (5.1) [2.0–12.1]a 
CNS stimulants–α adrenergic blockers 54 (5.4) [3.7–7.7] 0 (0.0) 1 (0.4) [0.1–3.4]a 8 (4.1) [1.8–9.2]a 33 (13.8) [8.5–21.5]*** 0 (0.0) 12 (8.7) [4.5–16.1]a*** 
Bronchodilators–nasal preparations 56 (5.3) [3.6–7.7] 1 (0.9) [0.1–6.5]a 7 (4.6) [1.8–11.5]a9 (3.5) [1.6–7.6]a 25 (9.1) [5.4–14.9]* 5 (3.2) [0.7–13.0]a 9 (6.7) [3.2–13.7]a 
Leukotriene modifiers–nasal preparations 47 (4.9) [3.2–7.3] 0 (0.0) 4 (2.4) [0.9–6.3]a 11 (6.8) [3.1–14.3]a 21 (8.9) [5.5–14.1] 2 (2.5) [0.4–14.0]a 9 (5.2) [2.3–11.6]a 
Bronchodilators–antihistamines 50 (3.7) [2.6–5.1] 5 (4.2) [1.6–10.6]a 4 (2.0) [0.7–6.0]a 12 (6.1) [3.6–10.1] 18 (5.7) [3.2–9.9] 5 (2.3) [0.8–6.3]a 6 (2.5) [1.2–5.0]a 
CNS stimulants–atypical antipsychotics 38 (3.5) [2.3–5.2] 0 (0.0) 0 (0.0) 5 (4.8) [2.1–10.4]a 24 (8.2) [4.8–13.9] 2 (0.6) [0.1–2.5]a 7 (4.5) [1.8–10.6]a*** 
Nasal preparations–antihistamines 35 (3.4) [2.3–5.1] 0 (0.0) 0 (0.0) 6 (3.0) [1.5–5.7]a 20 (8.2) [4.8–13.6] 2 (0.6) [0.1–2.8]a 7 (5.3) [2.5–11.0]a*** 
CNS stimulants–antidepressants 33 (3.4) [2.1–5.6] 0 (0.0) 0 (0.0) 7 (3.6) [1.4–8.5]a 13 (5.4) [2.8–10.1]a 6 (2.5) [0.7–8.3]a 7 (5.6) [2.0–14.8]a 
Leukotriene modifiers–respiratory inhalants 42 (3.0) [2.1–4.4] 3 (2.1) [0.6–6.8]a 5 (2.7) [1.1–6.5]a 6 (2.4) [0.9–6.2]a 19 (6.9) [3.8–12.5]** 4 (1.0) [0.3–2.8]a 5 (2.3) [0.9–5.5]a 
Atypical antipsychotic–α adrenergic blockers 23 (2.6) [1.7–4.1] 0 (0.0) 0 (0.0) 2 (2.3) [0.5–10.8]a 15 (7.2) [4.0–12.5] 1 (0.7) [0.1–4.7]a 5 (2.9) [1.0–8.0]a 
CNS stimulants–antihistamines 24 (2.5) [1.3–4.6]a 0 (0.0) 0 (0.0) 7 (4.2) [1.7–10.2]a 13 (7.5) [3.5–15.4]a 2 (0.4) [0.1–3.1]a 2 (0.6) [0.1–2.9]a 
Bronchodilators–penicillins 38 (2.4) [1.6–3.5] 16 (12.0) [7.2–19.4] 12 (6.0) [3.2–10.9]a5 (1.9) [0.7–5.6]a 3 (0.7) [0.2–2.2]a 1 (1.3) [0.2–9.1]a 1 (0.4) [0.1–3.2]a 
Bronchodilators–CNS stimulants 26 (2.3) [1.4–3.9] 0 (0.0) 0 (0.0) 8 (4.2) [1.7–9.8]a 12 (3.2) [1.9–5.4] 1 (1.9) [0.3–12.9]a 5 (2.8) [0.8–8.9]a 
Antidepressants–anticonvulsants 11 (1.8) [0.8–4.4]a 0 (0.0) 0 (0.0) 2 (3.0) [0.7–12.3]a 2 (0.5) [0.1–2.1]a5 (3.5) [0.8–14.0]a 2 (2.1) [0.4–9.6]a 
Respiratory inhalants–adrenal cortical steroids 14 (1.7) [0.8–3.6]a 2 (1.7) [0.4–7.1]a 2 (1.7) [0.4–7.1]a 4 (4.6) [1.0–18.7]a 3 (0.9) [0.3–2.9]a2 (0.9) [0.2–4.1]a 1 (1.6) [0.2–11.0]a 
CNS stimulants–penicillins 22 (1.6) [0.9–3.0] 6 (4.9) [1.8–12.4]a 5 (2.3) [0.9–5.8]a 4 (1.9) [0.7–5.1]a 3 (1.3) [0.4–4.0]a 3 (1.7) [0.4–7.4]a 1 (0.4) [0.0–2.9]a 
Narcotic analgesics–NSAIDs 13 (1.6) [0.7–3.6]a 0 (0.0) 1 (0.2) [0.0–1.7]a 2 (1.0) [0.2–4.4]a 0 (0.0) 5 (2.4) [0.7–7.7]a 5 (4.2) [1.3–13.1]a 
Contraceptives–antidepressantsb 6 (2.9) [1.2–7.0]a 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 6 (5.3) [2.2–12.0]a 0 (0.0) 
Adrenal cortical steroids–leukotriene modifiers 22 (1.3) [0.8–2.2] 3 (1.9) [0.6–5.8]a 7 (3.9) [1.5–9.6]a 3 (1.1) [0.3–3.4]a 5 (1.3) [0.4–3.5]a 3 (0.9) [0.3–3.1]a 1 (0.3) [0.0–2.5]a 
Bronchodilators–antidepressants 8 (1.3) [0.5–3.1]a 0 (0.0) 0 (0.0) 0 (0.0) 3 (0.6) [0.2–2.1]a 4 (4.0) [1.3–11.2]a 1 (0.6) [0.1–4.7]a
Narcotic analgesics–penicillins 11 (1.2) [0.6–2.5]a 0 (0.0) 0 (0.0) 1 (0.4) [0.0–2.6]a 2 (0.7) [0.2–3.0]a 6 (3.3) [1.2–8.8]a 2 (0.8) [0.2–3.2]a
Adrenal cortical steroids–penicillins 12 (1.1) [0.5–2.3]a 2 (1.0) [0.2–4.0]a 5 (3.6) [1.4–9.4]a 1 (0.3) [0.0–2.1]a 2 (0.7) [0.2–2.8]a 2 (1.6) [0.3–8.3]a 0 (0.0) 
Bronchodilators–NSAIDs 13 (1.1) [0.6–1.9] 1 (1.4) [0.2–9.3]a 5 (3.0) [0.9–9.5]a 1 (0.6) [0.1–4.8]a 0 (0.0) 3 (1.3) [0.4–4.7]a 3 (1.0) [0.3–3.3]a 
Penicillins–macrolides 5 (1.0) [0.2–4.2]a 2 (6.0) [0.9–30.5]a 1 (2.7) [0.4–16.7]a*** 1 (1.1) [0.1–8.3]a 0 (0.0) 1 (0.5) [0.1–3.2]a 0 (0.0) 
Antidepressants–PPIs 5 (1.0) [0.3–3.1]a 0 (0.0) 0 (0.0) 1 (0.7) [0.1–5.0]a 1 (0.2) [0.0–1.5]a 3 (3.3) [0.9–11.4]a 0 (0.0) 
Contraceptives–dermatological agentsb 3 (2.1) [0.6–7.0]a 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 3 (3.7) [1.1–12.0]a 0 (0.0) 
Penicillins–nasal preparations 6 (0.8) [0.3–2.4]a 1 (5.6) [0.7–31.8]a 0 (0.0) 3 (2.0) [0.4–8.5]a 2 (0.8) [0.2–3.2]a 0 (0.0) 0 (0.0) 
Macrolides–nasal preparations 5 (0.6) [0.2–2.3]a 1 (5.6) [0.7–31.8]a 1 (0.3) [0.0–2.4]a** 0 (0.0) 2 (0.5) [0.1–2.0]a 1 (0.4) [0.0–2.8]a 0 (0.0) 
Bronchodilators–cephalosporins 6 (0.6) [0.2–1.5]a 1 (1.0) [0.1–7.6]a 4 (3.9) [1.2–11.8]a 0 (0.0) 1 (0.2) [0.0–1.6]a 0 (0.0) 0 (0.0) 
Penicillins–cephalosporins 4 (0.5) [0.2–1.5]a 2 (3.6) [0.6–18.5]a 2 (2.1) [0.5–8.0]a 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 
Prevalence of Combinations, No. (%) [95% CI]
Overall, n = 9930–5 y6–12 y13–19 y
Girls (n = 112)Boys (n = 159)Girls (n = 156)Boys (n = 244)Girls (n = 170)Boys (n = 152)
Bronchodilators–respiratory inhalants 123 (10.5) [7.9–13.7] 12 (10.1) [5.1–19.3]a 21 (21.4) [13.0–33.1]* 24 (13.8) [6.6–26.6]a 38 (12.0) [8.1–17.4] 11 (3.5) [1.7–7.0]a 17 (9.2) [5.1–15.9]** 
Bronchodilators–leukotriene modifiers 99 (8.2) [6.3–10.4] 6 (4.6) [2.1–10.0]a 12 (6.6) [3.0–13.8]a 20 (8.9) [5.6–13.8] 36 (12.7) [8.4–18.6] 11 (6.6) [2.6–15.8]a 14 (6.7) [3.5–12.6]a 
Bronchodilators–adrenal cortical steroids 96 (6.9) [5.1–9.2] 24 (15.8) [10.1–23.9] 29 (13.8) [8.0–22.7] 14 (10.4) [4.6–21.8]a 18 (4.4) [2.7–7.2]** 6 (3.1) [1.1–8.3]a 5 (5.1) [2.0–12.1]a 
CNS stimulants–α adrenergic blockers 54 (5.4) [3.7–7.7] 0 (0.0) 1 (0.4) [0.1–3.4]a 8 (4.1) [1.8–9.2]a 33 (13.8) [8.5–21.5]*** 0 (0.0) 12 (8.7) [4.5–16.1]a*** 
Bronchodilators–nasal preparations 56 (5.3) [3.6–7.7] 1 (0.9) [0.1–6.5]a 7 (4.6) [1.8–11.5]a9 (3.5) [1.6–7.6]a 25 (9.1) [5.4–14.9]* 5 (3.2) [0.7–13.0]a 9 (6.7) [3.2–13.7]a 
Leukotriene modifiers–nasal preparations 47 (4.9) [3.2–7.3] 0 (0.0) 4 (2.4) [0.9–6.3]a 11 (6.8) [3.1–14.3]a 21 (8.9) [5.5–14.1] 2 (2.5) [0.4–14.0]a 9 (5.2) [2.3–11.6]a 
Bronchodilators–antihistamines 50 (3.7) [2.6–5.1] 5 (4.2) [1.6–10.6]a 4 (2.0) [0.7–6.0]a 12 (6.1) [3.6–10.1] 18 (5.7) [3.2–9.9] 5 (2.3) [0.8–6.3]a 6 (2.5) [1.2–5.0]a 
CNS stimulants–atypical antipsychotics 38 (3.5) [2.3–5.2] 0 (0.0) 0 (0.0) 5 (4.8) [2.1–10.4]a 24 (8.2) [4.8–13.9] 2 (0.6) [0.1–2.5]a 7 (4.5) [1.8–10.6]a*** 
Nasal preparations–antihistamines 35 (3.4) [2.3–5.1] 0 (0.0) 0 (0.0) 6 (3.0) [1.5–5.7]a 20 (8.2) [4.8–13.6] 2 (0.6) [0.1–2.8]a 7 (5.3) [2.5–11.0]a*** 
CNS stimulants–antidepressants 33 (3.4) [2.1–5.6] 0 (0.0) 0 (0.0) 7 (3.6) [1.4–8.5]a 13 (5.4) [2.8–10.1]a 6 (2.5) [0.7–8.3]a 7 (5.6) [2.0–14.8]a 
Leukotriene modifiers–respiratory inhalants 42 (3.0) [2.1–4.4] 3 (2.1) [0.6–6.8]a 5 (2.7) [1.1–6.5]a 6 (2.4) [0.9–6.2]a 19 (6.9) [3.8–12.5]** 4 (1.0) [0.3–2.8]a 5 (2.3) [0.9–5.5]a 
Atypical antipsychotic–α adrenergic blockers 23 (2.6) [1.7–4.1] 0 (0.0) 0 (0.0) 2 (2.3) [0.5–10.8]a 15 (7.2) [4.0–12.5] 1 (0.7) [0.1–4.7]a 5 (2.9) [1.0–8.0]a 
CNS stimulants–antihistamines 24 (2.5) [1.3–4.6]a 0 (0.0) 0 (0.0) 7 (4.2) [1.7–10.2]a 13 (7.5) [3.5–15.4]a 2 (0.4) [0.1–3.1]a 2 (0.6) [0.1–2.9]a 
Bronchodilators–penicillins 38 (2.4) [1.6–3.5] 16 (12.0) [7.2–19.4] 12 (6.0) [3.2–10.9]a5 (1.9) [0.7–5.6]a 3 (0.7) [0.2–2.2]a 1 (1.3) [0.2–9.1]a 1 (0.4) [0.1–3.2]a 
Bronchodilators–CNS stimulants 26 (2.3) [1.4–3.9] 0 (0.0) 0 (0.0) 8 (4.2) [1.7–9.8]a 12 (3.2) [1.9–5.4] 1 (1.9) [0.3–12.9]a 5 (2.8) [0.8–8.9]a 
Antidepressants–anticonvulsants 11 (1.8) [0.8–4.4]a 0 (0.0) 0 (0.0) 2 (3.0) [0.7–12.3]a 2 (0.5) [0.1–2.1]a5 (3.5) [0.8–14.0]a 2 (2.1) [0.4–9.6]a 
Respiratory inhalants–adrenal cortical steroids 14 (1.7) [0.8–3.6]a 2 (1.7) [0.4–7.1]a 2 (1.7) [0.4–7.1]a 4 (4.6) [1.0–18.7]a 3 (0.9) [0.3–2.9]a2 (0.9) [0.2–4.1]a 1 (1.6) [0.2–11.0]a 
CNS stimulants–penicillins 22 (1.6) [0.9–3.0] 6 (4.9) [1.8–12.4]a 5 (2.3) [0.9–5.8]a 4 (1.9) [0.7–5.1]a 3 (1.3) [0.4–4.0]a 3 (1.7) [0.4–7.4]a 1 (0.4) [0.0–2.9]a 
Narcotic analgesics–NSAIDs 13 (1.6) [0.7–3.6]a 0 (0.0) 1 (0.2) [0.0–1.7]a 2 (1.0) [0.2–4.4]a 0 (0.0) 5 (2.4) [0.7–7.7]a 5 (4.2) [1.3–13.1]a 
Contraceptives–antidepressantsb 6 (2.9) [1.2–7.0]a 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 6 (5.3) [2.2–12.0]a 0 (0.0) 
Adrenal cortical steroids–leukotriene modifiers 22 (1.3) [0.8–2.2] 3 (1.9) [0.6–5.8]a 7 (3.9) [1.5–9.6]a 3 (1.1) [0.3–3.4]a 5 (1.3) [0.4–3.5]a 3 (0.9) [0.3–3.1]a 1 (0.3) [0.0–2.5]a 
Bronchodilators–antidepressants 8 (1.3) [0.5–3.1]a 0 (0.0) 0 (0.0) 0 (0.0) 3 (0.6) [0.2–2.1]a 4 (4.0) [1.3–11.2]a 1 (0.6) [0.1–4.7]a
Narcotic analgesics–penicillins 11 (1.2) [0.6–2.5]a 0 (0.0) 0 (0.0) 1 (0.4) [0.0–2.6]a 2 (0.7) [0.2–3.0]a 6 (3.3) [1.2–8.8]a 2 (0.8) [0.2–3.2]a
Adrenal cortical steroids–penicillins 12 (1.1) [0.5–2.3]a 2 (1.0) [0.2–4.0]a 5 (3.6) [1.4–9.4]a 1 (0.3) [0.0–2.1]a 2 (0.7) [0.2–2.8]a 2 (1.6) [0.3–8.3]a 0 (0.0) 
Bronchodilators–NSAIDs 13 (1.1) [0.6–1.9] 1 (1.4) [0.2–9.3]a 5 (3.0) [0.9–9.5]a 1 (0.6) [0.1–4.8]a 0 (0.0) 3 (1.3) [0.4–4.7]a 3 (1.0) [0.3–3.3]a 
Penicillins–macrolides 5 (1.0) [0.2–4.2]a 2 (6.0) [0.9–30.5]a 1 (2.7) [0.4–16.7]a*** 1 (1.1) [0.1–8.3]a 0 (0.0) 1 (0.5) [0.1–3.2]a 0 (0.0) 
Antidepressants–PPIs 5 (1.0) [0.3–3.1]a 0 (0.0) 0 (0.0) 1 (0.7) [0.1–5.0]a 1 (0.2) [0.0–1.5]a 3 (3.3) [0.9–11.4]a 0 (0.0) 
Contraceptives–dermatological agentsb 3 (2.1) [0.6–7.0]a 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 3 (3.7) [1.1–12.0]a 0 (0.0) 
Penicillins–nasal preparations 6 (0.8) [0.3–2.4]a 1 (5.6) [0.7–31.8]a 0 (0.0) 3 (2.0) [0.4–8.5]a 2 (0.8) [0.2–3.2]a 0 (0.0) 0 (0.0) 
Macrolides–nasal preparations 5 (0.6) [0.2–2.3]a 1 (5.6) [0.7–31.8]a 1 (0.3) [0.0–2.4]a** 0 (0.0) 2 (0.5) [0.1–2.0]a 1 (0.4) [0.0–2.8]a 0 (0.0) 
Bronchodilators–cephalosporins 6 (0.6) [0.2–1.5]a 1 (1.0) [0.1–7.6]a 4 (3.9) [1.2–11.8]a 0 (0.0) 1 (0.2) [0.0–1.6]a 0 (0.0) 0 (0.0) 
Penicillins–cephalosporins 4 (0.5) [0.2–1.5]a 2 (3.6) [0.6–18.5]a 2 (2.1) [0.5–8.0]a 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 

Estimates are restricted to children who report the use of ≥2 prescription medications.

a

Estimates are unreliable; relative SE >30%.

b

Estimates are restricted to girls.

***

P < .01; ** P < .05; * P < .10 by using χ2 tests to determine differences between girls and boys.

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