Recommendations from Egyptian pharmacies for children with acute respiratory illnesses

Abstract

In the early 1990s posing as parents field workers from the Programme for the Control of Acute Respiratory Infections solicited advice from pharmacy workers at 16 pharmacies on how to manage a child with an acute respiratory infection. Most of the time the person behind the counter referred the field worker to the owner or another pharmacist. In the scenario where a 6 week old infant was ill with fever and runny nose but was eating and behaving fine and in the 1 where a 2 year old child only had a dry cough and a runny nose pharmacy workers recommended a cough and cold preparation but asked no questions did not provide an antibiotic and gave no other advice. In the case of a 6 week old with a fever not eating well and had labored breathing they recommended a cough and cold preparation but not an antibiotic. In addition they asked questions and advised the field worker to take the infant to a physician. They did dispense an antibiotic however in the case of a 2 year old with fever and labored breathing in addition to a cough and cold preparation. They also asked questions and advised a visit to a physician. The recommended cough and cold preparations often were contraindicated for young children. Some of the ingredients included salicylate (increasing the risk of toxicity if taken with aspirin) codeine opium and ipecac. Contrary to what local physicians and Ministry of Health personnel believe pharmacists do not dispense antibiotics for cold symptoms. They did dispense them for those children with signs of pneumonia however. Therefore they knew enough to distinguish between mild and potentially serious illness. Perhaps the program can encourage the pharmacy worker to refer children with symptoms of lower respiratory infection to a physician.