Advisory emphasizes caution in prescribing cough syrups after reported child fatalities in Madhya Pradesh and Rajasthan.
The Directorate General of Health Services has released an advisory to all states and Union Territories, urging the careful prescribing and dispensing of cough syrups for children. This action follows a troubling situation where several deaths have been reported, allegedly linked to the consumption of these syrups in Madhya Pradesh and Rajasthan.
The advisory highlights that most acute cough illnesses in children are self-limiting and typically resolve without the need for pharmacological intervention. Furthermore, it explicitly states that cough and cold medications should not be prescribed for children under the age of two. For children aged between two and five, the use of such medications is generally discouraged unless under careful clinical evaluation and supervision. The health authority emphasizes strict adherence to appropriate dosing, limiting the duration of use, and avoiding multiple drug combinations.
In addition to the restrictions on medication, the advisory recommends non-pharmacological measures as the first line of treatment for children experiencing cough and cold symptoms. Parents are encouraged to focus on adequate hydration and rest. The health facilities and clinics are urged to ensure that any products dispensed are manufactured under Good Manufacturing Practices and formulated with pharmaceutical-grade excipients.
Recent reports indicate that eight children, aged between one and seven, have died in the last month in Madhya Pradesh and Rajasthan, with authorities suspecting cough syrup poisoning as a common cause of these fatalities. In response, health authorities in both states have issued restrictions and advisories while investigations are currently ongoing.
The Union health ministry has stated that tests conducted on cough syrup samples from Madhya Pradesh showed no presence of Diethylene Glycol (DEG) or Ethylene Glycol (EG), which are contaminants associated with severe kidney injury. Similarly, samples collected from Rajasthan were free from Propylene Glycol, another potential contaminant. However, the ministry has noted that the product in question is a dextromethorphan-based formulation, which is not recommended for pediatric use.
The issue of toxic cough syrups manufactured in India gained international attention in October 2022 when the World Health Organization issued a global alert regarding four such medicines produced by a pharmaceutical company in Haryana. This alert came after 66 deaths in The Gambia were linked to these medications, with many cases attributed to acute kidney failure. Toxicity in cough syrups has often been traced back to the use of industrial-grade glycerine or propylene glycol instead of pharmaceutical-grade versions, leading to serious health risks.
In July 2024, a concerning report emerged when cough syrup samples from over 100 pharmaceutical units across India failed quality control tests. This ongoing situation underscores the critical need for heightened vigilance in the manufacturing and dispensing of cough syrups, particularly those intended for children.
