Too low drug dose every 10th child

Ten percent of all children receive too low a drug dose

09/11/2013

A study shows that parents tend to reduce the drug dose in their children on their own, in order to harm the little ones and to protect them from side effects. Doctors of the University Children's Hospital Erlangen warn against this practice.

Every tenth child mistreated
Parents who want to protect their children from side effects and therefore dose the drugs on their own, too low, could endanger their offspring. How Doctors and Scientists of the Children and Adolescent Clinic of the University Hospital Erlangen and the Robert Koch Institute in a study („“) found that about one in ten children was mistreated by their own parents. According to the findings, in about ten to fifteen per cent of the cases, guardians administer too little medication to their little ones in order to harm them as little as possible. This could also be dangerous.

Lower dosage does not protect against side effects
„Due to the reduced administration of drugs, the effect often remains. This is fatal, especially with antibiotics, because it creates resistance“, the study leader PD Dr. Antje Neubert from the Erlangen University Children's Hospital. In addition, lower dosages would not protect against side effects. These unwanted side effects would also have to be accepted by the child, although in the worst case it would have no therapeutic benefit from the drug.

Therapeutic effect is missing
According to the study, every fifth antibiotic is administered to children in too low a dosage. „It may not happen to the children much, because the application was not necessary“, so Neubert. However, it quickly comes to the formation of resistance, when these funds are used too often and too low doses. The study director says: „A problem that is now taking a dangerous development.“ She also sees a drift away from the parents' original intention of protecting their children, in a completely different direction: „The therapeutic effect remains, but adverse effects still occur and previously effective therapies may not be available in the future.“

Many medications have not been tested for children
Another problem is that the little ones get medicines that are not approved for them, as many medicines are not tested for children. Thus, just over a third of the funds received were not approved for children. A communication from the University of Erlangen states that this so-called „Off-label use“ represents a significant risk. „Contrary to what we know about prescription data, there was a significant increase in the number of medications that were not taken by the children in compliance with the approval“, explained Neubert. The EU has already passed a pharmaceutical regulation in 2007, which requires pharmaceutical companies to test every new drug in studies with children. First progress would become apparent in the meantime.

Educational needs of the parents
The conclusion of Neubert: „We suspect that, for fear of adverse drug reactions, parents are more likely to give slightly less medicine than prescribed by the doctor or as read in the package leaflet. But you do not want to keep the medicine completely away after all.“ What is needed is an urgent education of the parents. Also the partly still applied rule „in children half the dose“ was long outdated, because it differentiates too little.

Culture of restrained use of medicines
The results of the Erlangen study are based on the data of the study on the health of children and adolescents in Germany (KiGGS) of the Robert Koch Institute. Over 17,000 children and adolescents or their parents were systematically questioned about their medication intake in recent weeks. At the moment, it is too early to say to what extent the observations could apply to other countries. „In Germany, we have a culture in which medicines are used with restraint. The high proportion of homeopathic and phytopharmaceuticals makes that clear. All the more it is necessary to provide comprehensive education and to eliminate false prejudices, so that our children are adequately treated with medicines and still protected to the maximum“, so Neubert. (Ad)

Picture: Helene Souza