Towards safer paediatric prescriptions
The deaths of children due to a cure which turned harmful should hopefully result in more awareness among doctors, parents/caregivers and pharmacies/pharmacists
The cough syrup linked-deaths of children in Madhya Pradesh has revived concerns not just of manufacturing norms but also irrational use/abuse of common medications. It’s an open secret that medicines from cough syrups to antibiotics can be bought over the counter in India, without a prescription. While the irrational use of antibiotics has given rise to antimicrobial resistance and rendered many patients unresponsive to most antibiotics, the overuse of cough syrups in children is particularly harmful.
An advisory issued by the Directorate General of Health Services (DGHS) on the rational use of cough syrups in paediatric populations highlights that cough and cold medications should not be prescribed or dispensed to children below the age of two years. It also stresses that any use should be after careful clinical evaluation, followed by close supervision, to ensure appropriate dosing and avoiding use of multiple drug combinations. A letter written by the Health Ministry to the Director of Health Services of all States and Union Territories reportedly mentions that most acute cough illnesses in children are self-limiting and often resolve without pharmacological intervention.
Medical professionals agree with this assessment. Dr Sujit Paul, CEO, Zota Healthcare in fact calls the advisory a milestone, marking the ‘New Age of Pediatric Medication Awareness’, highlighting how the conversation is shifting from “what to prescribe” to “whether to prescribe or not.” Dr Paul suggests that rather than turning to syrup prescriptions, clinicians can concentrate on educating caregivers, specifying under what conditions drug therapy is appropriate and when it is not. He also makes the point that the message can be used on all paediatric medications, antibiotics to vitamins. (See Dr Paul’s blog: https://www.expresshealthcare.in/ blogs/ guest-blogs-healthcare/the-new-age-of-pediatric-medication-awareness/451227/)
Public health expert Dr Sameer Bhati explains that while OTC cough medications may be safe in adult measured amounts, they could be poisonous to infants as their developing organs metabolise medications differently. Hence infants are more likely to experience side effects such as drowsiness, fast heart rate, vomiting, and, in the worst instances, shortness of breath. As he analyses, it’s not necessarily an issue of unsafe products but of unsafe use, self-diagnosis, estimation of doses at home, and dismissal of age-related medical advice.
His advice to healthcare professionals is that it’s time now to bid adieu to symptomatic treatment and move towards root-cause management. Echoing the DGHS advisory, Dr Bhati points out that cough and cold in infants are more frequently than not viral and self-limiting and call for acts of comfort and not drugs. The way forward is to train caregivers to distinguish between viral and bacterial infections, fluid hydration, and home remedies can limit unwarranted drug exposure. (See Dr Bhati’s blog: https://www.expresshealthcare.in/ blogs/guest-blogs-healthcare/from-syrups-to-safety-shifting-focus-in-child-healthcare/451211/)
But will clinicians stop prescribing cough syrups? Will parents stop buying and giving their babies and toddlers cough syrups? Will pharmacists, both online and offline, stop selling cough and cold medications without a prescription? The doctor/pharmacy knows that if they don’t write such prescriptions or give medications without a prescription, caregivers will simply walk over to the next doctor’s clinic or chemist shop.
Zooming out from this harsh reality, report after report highlights that India’s healthcare sector is an investor’s destination, with a wave of investor-driven consolidation underlining the sector’s strong fundamentals and growth potential. For instance, as per Grant Thornton Bharat’s Q3 2025 Pharma and Healthcare Dealtracker, India’s hospital sector recorded 19 deals worth USD 264 million. Multi-specialty consolidation gained pace in western India and NCR, while singlespecialty formats like dialysis, IVF, oncology, and women and child-care drove volumes. The health tech side saw steady volumes and moderate valuations, with investments concentrated in digital health, AI diagnostics, and patient engagement tools. The wellness and preventive care segment saw sustained growth, backed by consumer awareness, nutraceutical innovation, and digital-first health platforms. Deal activity in medical devices saw episodic but strategic M&A, especially in orthopaedic and cardiology devices; outbound deals expanded global access. And diagnostics and homecare saw selective consolidation, favouring scalable, regional, asset-light platforms.
But on the other side of investor confidence and bullish sentiment, are the tragic deaths which triggered the Health Ministry’s advisory on improper prescribing/dispensing of cough syrups. The deaths of children due to a cure which turned harmful should hopefully result in more awareness among doctors, parents/caregivers and pharmacies/pharmacists about the dangers of quick fixes like cough/cold medications and the merits of slow acting but more lasting holistic healing principles.
VIVEKA ROYCHOWDHURY, Editor
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