Why don’t you give her an antibiotic, then she can come back to school? This extraordinary advice was given to one of my nurses when her child missed school due to a cough. Now let’s leave aside the ethics of school teachers giving health advice to nurses, but where on earth did the idea come from that antibiotics help children with coughs? Let us go back to the 1930’s and Alexander Fleming working in my old Alma Mater, St Mary’s Hospital. He was culturing some bacteria, went away for some days, and came back and found the plates spoilt. Some mould, probably from the damp walls, had contaminated the plates. He was about to throw them away when he noted that the bacteria had died in the areas where the mould was. He did not discover penicillin. Moulds, penicillin or otherwise, were already known. Nor did he discover antibiotics: in fact he did nothing for some years, thinking it was only of academic interest, and the bactericidal mould was useful for helping to identify different bacteria. It took another Doctor, an American, to realize its clinical potential, just in time for the 2nd World War.

The realization that penicillin, a fungus that grew on mouldy bread, could be injected into humans and treat wound infections, was one of the greatest scientific discoveries of the last century. Doctors thought they were out of a job. Streptomycin, one of many soil fungi discovered in the 50’s brought TB under control. Modification of the molecules made oral treatment possible, and soon Doctors were giving these new wonder drugs for every infection.

Big Mistake!
Antibiotics kill bacteria. That is all they do. They do not stop coughs, nor do they stop diarrhoea, nor do they bring down fevers, reduce pain, make you healthier, make you live longer or make you better looking. They kill bacteria. Full stop
Not all bacteria are bad for us. Our bodies are teeming with bacteria, also viruses, yeasts, other fungi and various parasites. Some are actually essential for health. Almost all the bacteria that live on us and in our intestines are harmless, and by taking up residence prevent other microorganisms living there instead. As all ladies know, kill the lactobacillus and you get thrush!

In the ‘60’s Doctors gave penicillin or the new wonder drug ampicillin to every child with a fever hoping it would wipe out streptococcus and make rheumatic heart disease history. So a child has a virus. Doctor. sees a fever and a red throat and gives penicillin. Being a virus, a few days later the child gets a rash. Oh! Says the Doctor you’re allergic to penicillin! Wrong again. In my generation, it has now been shown that 9 out of 10 of us who were told we are allergic to penicillin are not. We were victims or a knee jerk reaction of giving antibiotics for every infection.

Ths sad thing is that now, 40 years later, history repeats itself. A new generation of Doctors, and even old codgers like myself who should know better, are giving antibiotics to anyone with an infection. Kampala has just had a new flu virus hit us like a tidal wave. Hundreds of children and adults with high fevers, often up to 40 degrees, sore throats, red eyes and a cough. Half of them are told it is malaria and are given artemether if they are lucky, and injection quinine if they are not, the rest are taking antibiotics. I have lost count