Guideline / position statementindependent cross-checkfull text checked I-LEG-110 standard review
NHS hospital advice for parents of children with G6PD deficiency
Glucose-6-phosphate dehydrogenase deficiency (favism or G6PD deficiency): Information for parents (leaflet PL296.2)
Overview
King's College Hospital NHS Foundation Trust. Patient information leaflet 2022
Fava beans are the only food that commonly causes attacks; a list of specific medicines, including some antibiotics, should be avoided.
Does the study support the specific claim? Partly · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Advise parents.
- How was the study done?
Patient leaflet.
- How many people, animals or samples were studied?
Not applicable.
- What was actually found?
Fava beans, mothballs and named drugs are triggers.
- How large was the observed effect?
Not applicable.
- What do the results mean in everyday life?
Tell doctors and pharmacists about the deficiency; other beans are fine.
- What are the study's limitations?
Local leaflet, conservative list.
- What does it say about Elawady's specific claim?
Partly supports, partly contradicts C-LEG-05.
- Do the results apply to Germany and Europe?
UK.
- What can explicitly not be concluded from this study?
It does not provide evidence grades.
Scientific in-depth review
1. Full reference
- Authors
- King's College Hospital NHS Foundation Trust
- Journal
- Patient information leaflet
- Year
- 2022
- Identifier
- Verification
- verified – PDF fetched and read 2026-10-26 (PL296.2 August 2022; review date August 2025)
- Retracted
- no
- Corrections
- none
- Extent checked
- full text
- Conflicts of interest and funding
NHS trust publication.
2. Research question
What should parents of children with G6PD deficiency avoid?
3. Study design and population
- Study design
- Guideline / position statement – Hospital patient information leaflet (paediatric haematology)
- Population
Children with G6PD deficiency and their parents
- Country
United Kingdom
- Period
2022
- Sample size
Not applicable
- Inclusion and exclusion criteria
Not applicable
4. Methods and endpoints
- Exposure / intervention
Foods, mothballs, drugs
- Comparator
Not applicable
- Endpoints
Acute haemolysis
- Statistical methods
Not applicable
5. Actual results
- Results
Fava/broad beans are 'the only type of food that commonly causes attacks'; effects worse with large amounts or raw beans; 'Runner beans and baked beans do not cause problems'. Drugs to avoid include the antibiotics dapsone, nitrofurantoin, sulphonamides (co-trimoxazole), quinolones (ciprofloxacin) and nalidixic acid, antimalarials (primaquine, Maloprim, pentaquine), rasburicase, methylene blue, flutamide and Chinese herbal medicines; mothballs (naphthalene). Symptoms (pallor, jaundice, dark urine, back pain, fever) need GP or A&E review. Aspirin and lentils are not listed; smelling is not mentioned.
- Absolute risks
Not applicable
- Authors' conclusion
Avoid known triggers and tell every prescriber about the deficiency; safe alternatives nearly always exist.
6. Strengths
- Practical paediatric guidance
- Fetched and read in full
7. Weaknesses
- Local trust leaflet, not a national guideline
- More conservative drug list than CPIC (I-LEG-107)
- Review date passed (August 2025)
8. Risk of bias
- Orienting tool
- none applicable
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- not assessable
- Rationale
Patient information; evidence base not cited.
9. Assessment of the statistical interpretation
Not applicable.
10. Relevance to the specific claim
Partly supports the antibiotic element of C-LEG-05 (some specific antibiotics are listed), contradicts the lentil element (only fava beans named as food trigger; other beans safe) and does not list aspirin.
11. Independent contrary findings
CPIC (I-LEG-107) rates sulfamethoxazole and ciprofloxacin as low-to-no risk.
12. Transferability to Germany and Europe
UK practice.
13. Overall methodological judgement
Shows that clinical guidance is specific: fava beans and a list of named drugs, not legumes, aspirin or antibiotics in general.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | not assessable |
| Precision of results | not applicable |
| Directness | direct |
| Reproducibility | replicated |
| Consistency with the overall evidence | mixed |
| Regional transferability | moderate |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
Harmonisation between conservative hospital lists and CPIC.
15. Linked fact checks
- In G6PD deficiency, haemolysis is triggered by merely smelling fava beans and by eating lentils, as well as by aspirin and antibiotics. – Studies with mixed or unclear results