Overmedication of children does more harm than good

Tuesday, February 14, 2006
Hera Diani, The Jakarta Post, Jakarta

Whether it's a simple case of the sniffles or the worrying onset of
diarrhea, parents here are likely to trust a doctor and his prescription
pad to put their children right.

Yet it's children who stand to suffer the most as victims of the
chaotic drug situation in the country.

With doctors prescribing them medicines they do not need, and the
danger of significant side effects, the country's kids are considered
overmedicated.

In a society with a tradition of self-medication, a recent study showed
about 70 percent of parents gave their toddlers more than four kinds of
drugs at one time to treat their illnesses.

More than 35 percent of toddlers were taking from five to seven
different kinds of medicine, according to Foundation of Concerned Parents'
spokeswoman Purnamawati S. Pujiarto.

Moreover, 85 children in the study had taken antibiotics, on the advice
of doctors, for every malady they suffered.

"This phenomenon is dangerous. First, not all diseases can be treated
with medicines -- like influenza, for example. Second,
such an amount of consumed drugs could harm our children's
health, especially their livers," said the pulmonary specialist.

Pharmacologist and physician Iwan Darmansjah said there were few
clinical trials -- tests done on humans to determine the efficacy of a new
drug -- specifically for children.

Tests showing the different reactions of the drugs in adults and
children, whose smaller body mass would affect how they were absorbed, are
also extremely rare.

"It was only in 1998 and 1999 that the FDA required pharmaceutical
companies to do the study on all medicines for children," the professor
emeritus at the University of Indonesia said, referring to the U.S. food
and drug regulating body.

"Before then, the data was always based on adults. It's not like a
child is a small adult that you can just halve the adult dosage the
dosage."

There have been a few studies since, he said, but none conducted in
developing countries.

"That's why children in Jakarta go to the same doctor every
two weeks, with the same disease, to receive the same, wrong
medication which reduces their immunity," he said.

"Ninety-five percent of the children are suffering from cough,
fever and cold, which should've been treated with a symptomatic
drug instead of stuffing them with antibiotics."

Executive director of the International Pharmaceutical
Manufacturers Group Parulian Simanjuntak said that clinical
trials of children were difficult to conduct due to ethical
concerns.

"A trial must be carried out voluntarily, where a person knows
what s/he is doing, the risks and so on. It is still being
debated whether children can give informed consent, as an adult
could, or whether parents can decide for the children. That's why
studies on children are not as wide as adults," Parulian said.

"And it's why pharmaceutical industries estimate the dosage
for children based on the dosage for adults."

Parulian said developed countries have discussed "assent
consent", where children can say yes or no about participating in
trials.

"But so far, it's still only under discussion."

Labels: drugs, health

Posted by hera at Tuesday, February 14, 2006 8:59 PM | Permalinks