The Directorate General of Health Services (DGHS) on Friday issued a cautionary advisory against prescribing or dispensing cough syrups to children below two years of age, following reports of multiple child deaths in Madhya Pradesh’s Chhindwara district.
The advisory noted that cough syrups are generally not recommended for children under five. For older children, usage should involve careful clinical evaluation, close monitoring, strict adherence to dosage, and the shortest effective duration while avoiding drug combinations.
"Cough and cold medications should not be prescribed or dispensed to children under 2 years. These are generally not recommended for ages below 5 years and above that, any use should follow careful clinical evaluation with close supervision and strict adherence to appropriate dosing, the shortest effective duration and avoiding multiple drugs combinations. Further, the public may also be sensitized regarding adherence to prescription by the Doctors," DGHS, under the Union Ministry of Health and Family Welfare, said in the advisory.
The directive follows the deaths of at least nine children in Chhindwara, who had been treated for fevers, colds, coughs, and kidney complications. A multi-agency probe was launched, and hospital cough syrup samples were tested.
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Initial laboratory investigations by the Ministry of Health and Family Welfare found no traces of contaminants such as Diethylene Glycol (DEG) or Ethylene Glycol (EG), known to cause severe kidney injury. The Madhya Pradesh State Food and Drug Administration also tested three syrup samples, confirming their safety.
NIV Pune examined blood and cerebrospinal fluid samples, identifying one case of leptospirosis, a bacterial infection typically spread through contaminated water. Further analysis of water, entomological vectors, and respiratory specimens is ongoing by NEERI, NIV Pune, and other laboratories.
"A multi-disciplinary team comprising experts from NCDC, NIV, ICMR, AIIMS Nagpur, and state health authorities is investigating all possible causes behind the reported cases. As regards the reports related to two deaths of children in Rajasthan because of contaminated cough syrup consumption, it has been clarified that the product in question does not contain Propylene Glycol, which can be a potential source of contaminants, DEG/EG," the Ministry said.
Separately, drug control officers from Delhi and Chennai inspected a pharmaceutical manufacturing unit in Sunguvarchatram, Tamil Nadu, in connection with the Chhindwara cases.
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