Medication - as little as possible, as much as necessary

Screaming, flailing children who spit out their cough syrup: Giving your child medication can be an ordeal for parents. «The rule for children's medication is: as little as possible, as much as necessary. Especially for painkillers and antibiotics,» says paediatrician Heidi Zinggeler Fuhrer from Chur. «Correct intake and dosage adapted to age and weight are particularly important for children under twelve.»
Prolonged medication therapy in children should be monitored by a doctor. That's why Heidi Zinggeler doesn't issue annual prescriptions: «I regularly check children on long-term therapy, such as asthma medication or cortisone ointments.» And: medication should be kept under lock and key, safe from children's hands.
Dr Markus Lampert, hospital pharmacist at the Bruderholz Hospital in Basel, says that medication misuse in children and adolescents is rare. «However, the indication can be problematic.» For example, the prescription of Ritalin. Lampert mentions another aspect: «Sick children have no place in society because their parents can't work.» For example, working parents are sometimes forced to give their child a quick dose of medication for a banal cold instead of keeping them at home.

Other effects in children

Lampert sees a major problem with research, «because many drugs have not been tested on children or are not specifically authorised for this age group. 80 per cent of all hospitalised children receive such drugs.» In technical jargon, this is referred to as off-label use. This means that a drug is used in a different way to that intended by its authorisation.
According to a study in the British Medical Journal, off-label use can lead to unforeseen side effects in children. Professor Johannes van den Anker from the University Children's Hospital Basel confirms the lack of knowledge in paediatric pharmacology: «This is because drugs are usually only tested on adults.» Not only are the metabolic processes different in children, there is also little data from healthy children. Studies are only carried out on sick children, which can change the results.
«There are ethical questions about the extent to which drugs can be tested on children and who gives their consent,» says paediatrician and pharmacologist van den Anker, who conducts research in this field with his institute.

Medicine cabinet for children

• Antipyretic and analgesic as a syrup or suppository
• Nasal drops, e.g. saline-based
• Clinical thermometer
• Disinfectant (water-based, it hardly burns)
• Dressing material for minor injuries
• List of the most important emergency numbers (paediatrician, nearest hospital, nearest pharmacy, tox centre)

Petra Seeburger
is an intensive care nurse, journalist and communications specialist. She has worked in the healthcare sector for 30 years.