Adherence to Federal Opioid Prescribing Guidelines in Children's Surgery

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].