DGHS advises against cough and cold medicines for children under two

The Directorate General of Health Services (DGHS) has issued an advisory to all states and Union Territories directing that cough and cold medicines must not be prescribed to children under the age of two.

The guidance comes after reports of child deaths allegedly linked to contaminated cough syrups in Madhya Pradesh.

The Union Health Ministry said that none of the syrup samples tested in Madhya Pradesh contained Diethylene Glycol (DEG) or Ethylene Glycol (EG), both of which are harmful contaminants known to cause serious kidney damage.

According to the DGHS, cough syrups are generally not recommended for children below five years. The advisory stated, "In our continuous efforts to ensure rational drug use and patient safety in pediatric care, this advisory reiterates the judicious prescribing and dispensing of cough syrups for children."

It highlighted three key points: most acute cough illnesses in children are self-limiting; cough and cold medications should not be prescribed for those under two, and for children above five, use should follow strict clinical evaluation, proper dosing, shortest duration, and avoidance of multiple-drug combinations. It also stressed the importance of non-pharmacological measures such as hydration, rest, and supportive care as first-line treatment.

Healthcare facilities and clinical establishments have been instructed to procure and dispense only products manufactured under Good Manufacturing Practices with pharmaceutical-grade excipients. The DGHS has also called for sensitisation of prescribers and dispensers across public and private sectors to ensure these standards of care are upheld.

The advisory has been circulated to state and UT Health Departments, district authorities, government dispensaries, PHCs, CHCs, district hospitals, and medical institutions for implementation.

Meanwhile, the Health Ministry said that a joint team from the National Centre for Disease Control (NCDC), National Institute of Virology (NIV), and Central Drugs Standard Control Organisation (CDSCO) visited Madhya Pradesh to collect cough syrup samples. A multi-disciplinary team, including experts from NCDC, NIV, ICMR, AIIMS-Nagpur, and state authorities, is also investigating the reported cases.

At present, 13 children are undergoing treatment, including eight in Chhindwara and Nagpur. Of these, three of the five admitted in Nagpur are on dialysis.