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.”
Source : The Jakarta Post