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Healthy Skepticism Library item: 3826

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: news

Overmedication of children does more harm than good
The Jakarta Post 2006 Feb 14
http://www.thejakartapost.com/yesterdaydetail.asp?fileid=20060214.B03


Notes:

Ralph Faggotter’s Comments:

“ 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. “

These appalling statistics suggest a kind of widespread medicalized child abuse in which the parents and their children are unwittingly caught up.

A process which in extreme cases could justifiably be called ‘Munchausen by Medical Proxy’.

Unfortunately it is not confined to Indonesia, but, in varying degrees in different places, is a world-wide phenomenon.


Full text:

Overmedication of children does more harm than good

National News – February 14, 2006

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.”

 

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Cases of wilful misrepresentation are a rarity in medical advertising. For every advertisement in which nonexistent doctors are called on to testify or deliberately irrelevant references are bunched up in [fine print], you will find a hundred or more whose greatest offenses are unquestioning enthusiasm and the skill to communicate it.

The best defence the physician can muster against this kind of advertising is a healthy skepticism and a willingness, not always apparent in the past, to do his homework. He must cultivate a flair for spotting the logical loophole, the invalid clinical trial, the unreliable or meaningless testimonial, the unneeded improvement and the unlikely claim. Above all, he must develop greater resistance to the lure of the fashionable and the new.
- Pierre R. Garai (advertising executive) 1963