Almost killed by the magic bullet

Ninety four years ago, Dr Alexander Fleming made a life-saving discovery in penicillin. He is the reason the world population now stands at seven billion! Despite the magical discovery, he wasn’t taken seriously until 10 years later, when he had given up and moved on. Today, we enjoy his gift of life without fully appreciating the wonder of it. 
Imani’s mother always joked that her daughter had the immunity of a horse! 

She was never sick for longer than a day, she had never needed antibiotics and God forbid, had only slept in a hospital the day she was born. Now she sat on the armchair by her daughter’s bed in the ICU stroking the tiny foot as it was the only part of Imani not buried under pipes and drapes. 

Imani had started school three months prior and like any other kindergarten child, she had started with the unending merry-go-round of colds and coughs. She bounced back fast enough and never really needed anything more than nose drops and an antihistamine.

However, this particular infection was nothing like the ordinary. The fever hit hard and she had trouble breathing. 

She was picked from school by a frantic mum, who called her paediatrician in a panic. 

She was advised to head to the emergency department directly. By the time they were pulling into the parking, Imani was convulsing from the high fevers. 

The emergency department team quickly stabilised Imani and brought the convulsions under control. The fever was settling as the doctor got down to doing a full evaluation of the child. Imani was diagnosed with severe tonsillitis and otitis media (ear infection). 

Under instruction of the paediatrician, Imani was put on a penicillin-based antibiotic for definitive treatment of the infection. This is the most commonly prescribed first choice antibiotic for bacterial infections. Imani received her first intravenous dose at the emergency department and was wheeled to the ward for admission. By the time she was being settled in to bed, she was beginning to break out in hives. She turned pink and was itchy all over in record time. Imani had an allergic reaction to the penicillin. 

The nurse called for immediate help and the responding team managed to put the reaction under control. It was a close shave for Imani. The paediatrician put a stop to the penicillin and changed the prescription to a different group of antibiotics. Eight hours later, the second dose was given to Imani with caution, under close watch of the paediatrician. 

In a record five minutes, the hives were back. The crash cart was ready for her but the allergic reaction was immensely violent. Angry red splotches sprouted all over her skin like mushrooms and she began to wheeze. Imani had to be intubated to protect her airway from shutting down and she was transferred to the intensive care unit for critical care. 

The care team was back to the drawing board. The dilemma was having the courage to try a different antibiotic with the hope that it would work without trying to kill her. Meanwhile, the bacteria in her body were having a field day. There was need to reign them in as soon as possible. 

The third attempt was done with Imani in the ICU. The paediatrician mumbled a prayer as she set up the intravenous infusion under the watchful eye of the critical care specialist. They all remained glued to the monitors, with eyes darting to the frail little person on the bed. For the next hour, no one moved. Imani’s readings on the monitor remained stable and slowly everyone began to exhale. 

The weary paediatrician came out to find Imani’s mother, sharing the good news with a sigh of relief. The two women sat on the couch, sharing a moment of silent understanding. Our little horse had caved in and the attempt to restore health had nearly cost her life. 

Antibiotics are life-saving, there is no doubt about it. We cannot live without them. However, like all other medicines, they too can cause life-threatening allergic reactions and other adverse effects. We must treat them with the respect they deserve!

Dr Bosire is an obstetrician/gynaecologist