Citizen's Comfort

ANTIBIOTICS USE IN CHILDREN. WHAT IS SAFE AND WHAT IS RISKY? -DR OMOLOLA LAMINA

Antibiotics refer to a group of drugs used to kill or stop infections caused by bacteria. Bacteria are tiny single- celled organisms that survive on nutrients they obtain in their environments within or outside the human body. Not all bacteria are detrimental to the human body. Indeed some are useful in the living body and are referred to as the” normal flora”.

The word antibiotics itself means “against life” of the bacteria. Antibiotics are prescribed and used to kill harmful bacteria which disrupt good and optimal health of the human body. This they do by killing the bacteria or preventing their growth by keeping them from multiplying in the human body. In the era before the discovery of antibiotics in the 1920s, many people died from minor bacterial infections like sore throats and urinary tract infections. The advent of antibiotics since it became widely available in the 1940s was accompanied by an increased life expectancy, improved or better surgical outcomes and many individuals now survive conditions previously known as deadly infections.

The good human body bacteria referred to as the ”normal flora” exist in many systems of the body such as the digestive system, genitourinary system, ear, nose and throat as well as the skin. In good health these bacteria are present and pose no threat to the human body but rather assist in the normal functioning of these systems. On the other hand, there are some bacteria that are bad for the human body they colonize various systems when an individual becomes immunosuppressed, immunocompromised  or in rare cases when the normal bacteria flora earlier mentioned has been destroyed by a breach of skin, mucosa lining or excessive use of antibiotics.

No doubt antibiotics play a huge role in helping to fight various bacterial infections detrimental to human health but for one to reap the benefits of using them we must bear in mind the rationale use of antibiotics. The rationale use of antibiotics refers to the use of antibiotics for the appropriate type of infection, via the right route of administration, given at the right dose and over the appropriate duration of time for treatment of that infection. Antibiotics are required for the treatment of varying bacterial infections ranging from ear infections, throat infections, pneumonias, boils to urinary tract infections in children. But, without the rationale use of antibiotics the benefits of use of antibiotics remain futile and in fact poses more harm than good to the individual on the long run.

The appropriate prescription to use any antibiotic should be made a doctor after taking a good history and adequate examination of the child at presentation at the health facility. The doctor may prescribe an antibiotic based on available local susceptibility patterns of the disease in that environment while awaiting the definitive results of blood investigations and culture aimed at isolating the causative organism and the drug the organism is sensitive too. The antibiotics are prescribed using body weight calculations in children to obtain the appropriate dose and prescribed over an average of 5 to 7 days orally depending on the type and severity of the infection. In rare and severe infections the child may need to be admitted to give antibiotics via the intravenous route and treatment may last as long as 14 to 21days. Other conditions put into consideration before prescribing an antibiotic in a child includes the premorbid condition such as presence of an underlying heart, kidney or liver problems. Antibiotic doses may be reduced as appropriate where such underlying conditions exist.

A major risk of inappropriate use of antibiotics is the development of drug resistance, a condition in which the individual does not get well or better with appropriate use of an antibiotic known to be generally effective for treating that particular infection for which it has been used for. Sadly, this is gradually becoming the new reality in our environment. Factors leading to this include indiscriminate buying of antibiotics in pharmacies and abuse of use of antibiotics by individuals without seeking a prior expert management by a managing doctor. An increase in the number of drug peddlers selling drugs they have no knowledge of, many pharmacists prescribing and selling medications to individuals who present at their pharmacies and the attempt by parents or caregivers to cut the down cost of paying an expert who will properly examine and investigate the cause of infection, the use of antibiotics for non bacterial infections as well lack of government policies to prevent the indiscriminate abuse of antibiotics in our environment. Other complications that may stem from indiscriminate use of antibiotics may include severe adverse reactions an example such as a rare complication of Steven Johson syndrome leading to death that may accompany use of sulphonamide antibiotics such as septrin in some individuals and organ failures of the kidneys and/ or liver.  To prevent complications of using antibiotics, the solutions therefore are obvious. The rationale for the use of antibiotics must be strictly adhered to! Avoid indiscriminate use of antibiotics, see an appropriate health care professional to examine your child/ ward thoroughly who will prescribe appropriately the antibiotic of choice while awaiting definitive investigations.

In conclusion, while antibiotics are very useful and life saving as they help cure and return good health back to individuals who come down  with bacterial infections, they are not without their own risks and side effects. Hence, they should be used only with appropriate prescription and with caution to ensure that only the benefits of its use are reaped maximally.

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