Indonesia: Medicinal syrup ingredients may be linked to child deaths from acute kidney injury
Officials are looking at a number of medicinal syrups used to treat fevers, coughs and colds, with concerns that some may have dangerous levels of ethylene glycol.

Thursday 20 October 2022 21:47, UK

Cough medication. File pic
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Cough medication. File pic
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Almost 100 children in Indonesia have died from acute kidney injury (AKI) this year in cases which could be linked to contaminated medicines, prompting an urgent investigation by authorities.

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The country’s food and drug monitoring agency said it was tracing 26 medicinal syrups used to treat fevers, coughs and colds.

Tests showed that some of the medicines had ethylene glycol levels “that exceeded the safe threshold”, the agency said.

The sales of such medicines were banned on Wednesday, although the agency said it cannot be certain that the products are solely responsible for the illness.

Some 206 cases of AKI had been identified among children, with 99 deaths across 20 provinces – a fatality rate of 48%.

Health ministry spokesperson Mohammad Syahril said: “Previously, there were only a few cases of kidney injuries, only one or two every month.

“But at the end of August there was a spike in cases that got our attention.

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“It is an atypical progressive acute kidney injury.

“We call it atypical as the cause is still under investigation or unknown.”

A number of possible causes being investigated

The agency also said that other factors can contribute to acute kidney injury, however, and these are also being investigated.

There is no evidence that the injuries could be connected to the COVID-19 vaccine or virus infection, Mr Syahril added.

Health officials in Gambia are dealing with a similar situation, with 70 children having died from AKI and some paracetamol syrups suspected of containing excessive levels of diethylene glycol and ethylene glycol.

The Gambian cases are thought to be linked to cough syrups made by New Delhi-based Maiden Pharmaceuticals.

Factory shut down in India

The drugs are thought to have been made in a single batch in December last year with a use-by date of November 2024, Indian health authorities said. They were all approved for export only to Gambia.

The UN health agency said that laboratory analysis of four Maiden products – Promethazine Oral Solution, Kofexmalin Baby Cough Syrup, Makoff Baby Cough Syrup and Magrip N Cold Syrup – had “unacceptable” amounts of diethylene glycol and ethylene glycol, which can be toxic and lead to acute kidney injury.

One of Maiden’s factories in northern India has been shut down while authorities there investigate.

Maiden executive Naresh Kumar Goyal declined to comment.

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