I wish to share my experience regarding misuse of corticosteroids in pediatric practice since 1993, when I returned from Gulf and settled in city of Ujjain (MP). It is not surprising to see irrational prescriptions of corticosteroids from qualified pediatricians. Corticosteroids are frequently misused in respiratory infections, acute bronchiolitis and prolonged fever. Prescriptions are also written advising injectable steroids to be mixed with injectable antibiotics on outpatient basis (eg. Inj. amoxicillin with Inj. dexamethosone).

Betamethosone in drop form is available in our country since long time. I personally feel that it is one of the most misused corticosteroid given orally to young infants. I evaluated the consumption of betamethesone drops in Ujjain and Shajapur district in last 3 years. The sale of one of the leading brands "Betnesol drops" manufactured by Glaxo company in last 3 years was 24,200 (2006), 22138 (2007) and 30140 (2008) bottles, respectively. These figures were shocking. The exact sale of one more brand, Stemin drops manufactured by Ind-Swift Co. was not available, but rough estimation of sale provided to me was around 8000 bottles per year. Apart from these two if we also include the sale of generic formulation (approximately 6000 bottles per year) then the total number of bottles of betamethasone drops sold goes beyond 40000 per year. If this is the situation in small district of Ujjain and Shajapur, then one can imagine the situation at state or national level; the figure may be in millions. I was also informed that for many years company has stopped promoting this product to doctors, yet the sale remains unaffected.