Why every antibiotics dose matters to a child

Children are known to be most gullible to diseases, as their immunity is only on a growing path and many a time, medical prescriptions are needed to either reinforce their defence, or help minimise the damage by diseases once they fall ill. There is always a danger of not bringing a child to healthcare for adequate management. Although not every sore throat and not every sneezing is worth antibiotics, there is always a risk of getting a serious and lifelong condition, owing to the fact that childhood throat infections were not taken care of in a proper manner. One of the dangers is the disease named Rheumatic Heart Disease, which emanates from a neglected bacterial (from Group A Streptococcus) sore throat infection that occurs in early childhood and takes its time to show up in the human system, even if fewer cases (3% at least) may develop the disease. Worldwide, over 15 million cases of Rheumatic Heart Disease and about 282,000 new cases of the same disease are reported worldwide every year, and about the same number of subsequent deaths. In Rwanda, 2014 data shows that about 200 children are on the waiting list for surgery over this very disease; however, the national prevalence of the disease is hardly known. Currently, no vaccine is available to prevent children from Group A Streptococcus and the only preventive measure is maintaining hygiene standards like hand washing and keeping the child as far from an infected person as possible. Oral antibiotics may help cure the milder forms of the disease, but severity would be best approached by hospitalisation and drugs administered by the intra venous route. The disease is thought to come from the fact that the anatomical lining of the throat may somehow be similar to that of the heart and to some extent, to that of the kidney as well. As the germs spread via blood, they can mimic and apply the same fate they reserve for the throat but at a much higher scale. It is hence really easy to get a chronic heart or kidney condition which would require surgery in some cases for relief and survival. Such children also need a continuous follow up and treatment. You would not really wish to see how miserable an affected child can look. The germs affect the cardiac anatomy, the valves most especially, which are the pathways of the blood getting in and out of the heart, and their severity is represented by a consequent failing heart, from their valve-narrowing mechanism. Rheumatic Heart Disease is not only fatal to the heart but affects the joints and, as well, get generalised (systemic) with time. These facts show how much public health importance this condition should be given. Remember, it only requires a parent taking his child to be given healthcare early enough to be prevented from this disease. Laboratory tests– although not always available in the country– have to be carried out; medications as well, should be well thought of, and parents have the right to ask what the medication does, which side effects and what would have been the consequences if ever that medication is not taken. I happen to belong to a school of thought that preaches not to prescribe heavy antibiotics for relatively small infections. It is not that a parent has a good medical insurance that fancy named and non-cost effective medications should be prescribed. Medication needs serious evidence back-up while being prescribed. So, dear parents, do not neglect a sore throat; it might be a serious disease that may yield severe consequences. Gone are the days when a mother would give a homemade ingredients’ mix to cure a cold or a fever. The writer is a medical doctor at Ruhengeri Hospital, Musanze District