Strong medicines killing children

The benefits of medicines outweigh the risks

More than 150 children have died in the past 10 years in the UK after taking prescribed medicines, according to research.

The figure compares to a total of 181 deaths during the previous 25 years.

The deaths are believed to have occurred as a result of side-effects to powerful drugs.

For all the medicines studied the overall benefit to children is likely to be far greater than the risk

Prof Imti Choonara

However, the doctors who carried out the research suggested death rates could be even higher since fatal reactions to drugs "are significantly under reported".

Professor Imti Choonara and colleagues at the University of Nottingham based their findings on figures supplied by the government's Medical Control Agency.

Early-warning system

The MCA has operated a so-called yellow card scheme since 1964. It operates as an early-warning system bringing possible problem drugs to the attention of authorities.

Doctors are encouraged to report adverse reactions and deaths they believe to be associated to medication to the MCA.

The scheme is voluntary and doctors are not obliged to lodge a report.

The researchers found that a total of 331 children died as a result of suspected drug reactions between 1964 and 2000. Half of these deaths have occurred since 1991.

The study found that some types of drugs were suspected of causing a fatal reaction in patients compared to others.

For instance, some anti-epileptic drugs were associated with 65 deaths. Chemotherapy drugs were linked with a further 30 deaths while antibiotics were suspected of causing 29 deaths.

The increase in deaths in the past 10 years is against a backdrop of increased reporting by doctors.

The study shows that the number of reports of suspected adverse drug reactions made to the MCA has increased sharply in recent years.

Between 1996 and 2000, doctors reported almost 19,000 incidents. This compares to just 350 between 1966 and 1970.

Writing in the journal Archives of Disease in Childhood, the researchers acknowledged that they could not be sure that the medication was the cause of death in each case.

They wrote: "Details that may explain the deaths, such as the nature of the underlying disease or co-administered drugs, may be lacking from the report."

However, they added: "We believe that the 331 deaths reported as associated with [adverse drug reactions] is likely to be an underestimate, as it is well recognised that [these reactions] are significantly under reported."

More research

The doctors called on the government and the pharmaceutical industry to carry out more research into the risk-benefits of medicines prescribed to children.

They also suggested that the medical profession "need to be more aware of guidelines which recommend avoiding medicines in certain high risk groups".

The researchers added that the benefits of all prescription medicines outweighed any risks.

"Our study has not looked at evaluating the benefit of medicines but for all the medicines studied the overall benefit to children is likely to be far greater than the risk."

In an accompanying editorial, Dr Harvey Marcovitch, the journal's editor, said: "We hope that paediatricians will learn from the prime message of this paper, namely that they should make themselves aware of guidelines which recommend avoiding certain medications in high-risk groups."

UK charity Action Research said the report highlighted the need for urgent research.

Simon Moore, its chief executive, said: "We should never be in the hazardous situation where prescribing drugs for children and babies is based on assumption, or even worse guesswork.

"Children are not little adults, and a campaign we have been running for the last two years calls for the proper licensing and testing of drugs used in youngsters.

He added: "Patients and doctors must have the confidence that drugs have been adequately tested in the first place."