Abstract:
Background
Cough syrups are widely used in the developing world, but safety of their use in infants and
children less than two years has not been well documented. Some syrups contain multiple
combinations of such drugs as promethazine, diphenhydramine and ephedrine; which are
individually now contraindicated in children less than two years. Despite this, the syrups are
available as over the counter drugs and may be dispensed to mothers who are unaware of
the potentially hazardous effects to their infants. A descriptive cross-sectional study was
used to investigate suitability of cough syrups sold within Eldoret municipality for use in chil-
dren less than two years of age based on their formulations and available literature.
Methods
Two semi-structured questionnaires were administered to pharmacy attendants and moth-
ers attending sick child clinic at a referral hospital to establish whether cough syrups con-
taining more than one active ingredient of compounds, now contraindicated in children are
administered to infants, and awareness of potential serious adverse effects. Data from
labeled contents of cough syrups from retail pharmacies was recorded and corroborated
with information from literature to determine those deemed to contain the ingredients. The
second questionnaire was administered to mothers with children less than two years to
ascertain whether they had used the identified syrups. A total of 260 mothers and 55 phar-
macy attendants were interviewed.Results
There was widespread use of the syrups in children, including infants, with 192 (74%) of the
respondents having used identified syrups and over 90% of these on children less than 2
years including those less than three months.146 (76%) mothers had administered the
syrup at double the recommended dose.
Conclusion
The regulatory authorities should make concerted efforts to discourage use of cough syrups
containing ingredients that pose adverse events to infants, including campaigns to educate
pharmacy workers and mothers.