Avoid cough syrups for kids under 2 years, Centre issues advisory

New Delhi: The Centre has issued an advisory to all states and Union Territories cautioning against prescribing cough and cold syrups to children below two years of age.

The directive, issued by the Directorate General of Health Services (DGHS), follows reports of child deaths allegedly linked to contaminated cough syrups in Madhya Pradesh. However, the Union Health Ministry clarified that none of the tested syrup samples contained Diethylene Glycol (DEG) or Ethylene Glycol (EG) — toxic contaminants known to cause kidney damage.

The DGHS advisory further noted that cough syrups are generally not recommended even for children below five years. For older children, it stressed that prescriptions should be based on careful clinical evaluation, strict dosage adherence, the shortest possible duration of use, and avoidance of multiple drug combinations.

“Most acute cough illnesses in children are self-limiting and resolve without pharmacological intervention. Non-pharmacological measures like hydration, rest, and supportive care should be the first line of treatment,” the advisory stated.

Healthcare facilities have been instructed to ensure procurement of medicines manufactured under Good Manufacturing Practices and formulated with pharmaceutical-grade excipients. States and Union Territories have been asked to disseminate the guidelines across government and private hospitals, PHCs, CHCs, and dispensaries.

Earlier in the day, the Health Ministry said a multidisciplinary team, including experts from the National Centre for Disease Control (NCDC), National Institute of Virology (NIV), and Central Drugs Standard Control Organisation (CDSCO), had collected syrup samples in Madhya Pradesh. Tests ruled out DEG/EG contamination, while one blood sample from a child tested positive for leptospirosis.

Investigations are continuing, with further analysis of water, environmental vectors, and respiratory specimens under way at NIV Pune, NEERI, and other laboratories.

The ministry also addressed reports of two child deaths in Rajasthan, clarifying that the product in question was a dextromethorphan-based formulation, not recommended for paediatric use, and did not contain propylene glycol, another possible source of contamination.