Adulterated cough syrup caused acute kidney failure deaths in children: lessons have still not been learnt.

In 2025, 24 children in India died after consuming COLDRIF, a paediatric cough syrup, due to acute kidney failure. Batch SR-13 from Sresan Pharmaceuticals in Tamil Nadu, India,was contaminated with 46.28 % diethylene glycol (DEG), a toxic solvent used in place of pharmaceutical-grade excipients. Kidney biopsies from children confirmed acute tubular necrosis. DEG toxicity, via its metabolites 2-hydroxyethoxyacetic acid and diglycolic acid, causes metabolic acidosis and nephrotoxicity. Global incidents highlight repeated risks of DEG adulteration in children medicines. Regulatory lapses and poor-quality control remain major contributors. Strict adherence to Good Manufacturing Practices and vigilant regulatory oversight are essential to prevent such fatal outbreaks.