Dear Editor-in-Chief
Self-medication (SM) is the use of non-prescribed medicines by individuals to treat self-recognized disorders or symptoms (1, 2). SM can include the use of conventional medicines (CM) or a wide range of complementary and alternative medicine (CAM). There are advantages and disadvantages of SM (1–3). The prevalence of SM in children ranges between 7.1 to 58.8% (3–7). In general, parents or legal guardians perform the SM (3–7).
We aimed to evaluate the characteristic and frequency of SM (CM and CAM) of Mexican pediatric patients in a hospital outpatient department. The Ethics and Investigation Committees approved the study protocol, and the study was performed according to the guidelines delineated by the Declaration of Helsinki.
A total of 941 parents or legal guardians with a mean age of 31.7 (±8.7) yr were evaluated. The mean age of the children was of 56.6 (±81.6) months. Five hundred forty children were male (57.4%). Respiratory (24.9%), nervous and musculoskeletal system (18.1%), gastrointestinal (13.6%), skin (8.8%), and psychological or psychiatric (7.8%) diseases were the main consultation diagnoses. Three-hundred-fifty-seven (37.9%) parents or legal guardians gave CM to their children before going to the hospital. Five-hundred-twenty-two CMs were administered to the children, with an average of 1.46 medicines/child, being the antipyretics/non-steroidal anti-inflammatory drugs (NSAIDs) the main group. The commonest source about the information of the medicines was by old prescription in 237 (66.4%) cases and in 88 (24.6%) cases the drugs were indicated by parents or legal guardians. Table 1 shows the CM groups used by the parents or guardians of the children.
Table 1:
Number of medications (CM) by pharmaceutical group.
| Variable | n | % |
|---|---|---|
| Antipyretic and non-steroidal anti-inflammatory drugs | 389 | 74.5 |
| Paracetamol | 289 | 74.3 |
| Metamizol | 34 | 8.7 |
| Nimesulide | 28 | 7.2 |
| Others | 38 | 9.8 |
| Ear, nose, throat, respiratory medications | 65 | 12.5 |
| Ambroxol | 36 | 55.4 |
| Amantadine, chlorpheniramine, paracetamol | 7 | 10.8 |
| Loratadine | 6 | 9.2 |
| Others | 16 | 24.6 |
| Antimicrobial medicines | 50 | 9.4 |
| Trimethoprim-sulfamethoxazole combination | 15 | 30.0 |
| Ampicillin | 12 | 24.0 |
| Amoxicillin | 12 | 24.0 |
| Others | 11 | 22.0 |
| Gastrointestinal medicines | 16 | 3.1 |
| Butylscopolamine | 7 | 43.8 |
| Bismuth subsalicylate | 2 | 12.5 |
| Others | 7 | 43.8 |
| Others | 2 | 0.4 |
CM = Conventional medicines
Three-hundred-one (32.0%) parents or legal guardians gave CAM to their children before going to the hospital. Five-hundred-two CAMs were administered to the children, with an average of 1.67 CAM/child. Table 2 shows the CAMs used by the parents or legal guardians of the children, being the chamomile infusion the main administered CAM.
Table 2:
Number of CAMs administered in children by parents or legal guardians (n=301)
| Variable | n | % |
|---|---|---|
| Chamomile (Matricaria chamomilla) infusion | 212 | 42.2 |
| Peppermint (Mentha × piperita L. ) infusions | 93 | 18.5 |
| Cinnamon (Cinnamomum verum) infusions | 28 | 5.6 |
| Honey with lemon beverage | 16 | 3.2 |
| Lemon grass (Cymbopogon citratus) infusions | 15 | 3.0 |
| Leaf of Guava (Psidium guajava L. ) infusions | 9 | 1.8 |
| Melissa (Melissa officinalis) infusions | 9 | 1.8 |
| Oregano (Origanum onites L ) infusions | 8 | 1.6 |
| Mullein (Verbascum Thapsus) infusions | 8 | 1.6 |
| Eucalyptus (Eucalyptus tereticornis) infusions | 8 | 1.6 |
| Honey alone | 8 | 1.6 |
| Bougainvillea (Bougainvillea spectabilis) infusions | 7 | 1.4 |
| Olive oil | 6 | 1.2 |
| Prune (Prunus domestica) infusions | 5 | 1.0 |
| Cedar tea | 5 | 1.0 |
| Wormwood (Artemisia absinthium L ) infusions | 4 | 0.8 |
| Rue (Ruta graveolens) infusions | 4 | 0.8 |
| Others | 57 | 11.4 |
CAM = Complementary and alternative medicine.
The commonest source about the information of the CAMs was by grandparents or relatives in 197 (65.4%) cases and in 67 (22.3%) cases the CAMs were indicated by parents or legal guardians. With respect to the annual frequency of SM (last 12 months), 626 (66.5%) parents self-medicate with CM and 435 (46.2%) with CAM.
Parents or legal guardians used CMs in SM with a mean of 3.5 ± 2.9 times/year. Parents or legal guardians used CAMs with a mean of 3.9 ± 3.4 times/year. Four-hundred-twenty-four (45.1%) parents or legal guardians administered CM in self-decision to children during the last year and 367 (39.0%) parents or legal guardians managed CAMs to children. The annual means of the administration of CMs to children was of 2.9 ± 2.2 times/year and of CAMs was of 2.9 ± 2.4 times/year. Significant correlation coefficients were found for the SM (CM and CAM) frequency of parents with the frequencies of CM and CAM administered to the children (P<0.05).
We found data on common CM and CAM used as SM in Mexican children. Parents or legal guardians are responsible for the care of their children and they must consider the security of these interventions to reduce adverse o deleterious effects in children.
Footnotes
Conflict of interests
The authors declare that there is no conflict of interests.
References
- 1.Bennadi D. (2014). Self-medication: A current challenge. J Basic Clin Pharma, 5: 19–23. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.World Health Organization (WHO) (2013). Traditional Medicine Strategy 2002–2005. World Health Organization; http://apps.who.int/medicinedocs/en/d/Js2297e/4.2.html. Accessed March 3, 2017. [Google Scholar]
- 3.Zuzak TJ, Boňková J, Careddu D, et al. (2013). Use of complementary and alternative medicine by children in Europe: published data and expert perspectives. Complement Ther Med, 21 Suppl 1: S34–47. [DOI] [PubMed] [Google Scholar]
- 4.Du Y, Knopf H. (2009). Self-medication among children and adolescents in Germany: results of the National Health Survey for Children and Adolescents (KiGGS). Br J Clin Pharmacol, 68: 599–608. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 5.Pereira FS, Bucaretchi F, Stephan C, Cordeiro R. (2007). Self-medication in children and adolescents. J Pediatr (Rio J), 83: 453–8. [DOI] [PubMed] [Google Scholar]
- 6.Bham SQ, Saeed F, Shah MA. (2016). Knowledge, Attitude and Practice of mothers on acute respiratory infection in children under five years. Pak J Med Sci, 32: 1557–61. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 7.Soriano Hernández R, Reyes-Hernández U, Reyes Hernández D, Reyes Gómez U, García-Galavíz JL, Garzón Sánchez E. (2009). Frecuencia de automedicación en niños con infección respiratoria aguda en un área rural. Rev Fac Med UNAM, 52: 110–3. [Google Scholar]