Too Much of a Good Thing?

 It all happened so fast, recalls Suzanne Michaelson. One minute she was getting ready to put her feverish three-year-old, Katie, to bed. The next, her daughter was foaming at the mouth, eyes rolling back in her head, and Michaelson was screaming to her husband to call 911.

Before long, an ambulance arrived to speed Katie to Children’s Hospital in Columbus, about ten miles from the Michaelsons’ suburban Ohio home.

By then, the seizure had worsened: Katie’s breathing was shallow, her oxygen levels plunging. Paramedics stabilized her by inserting a breathing tube down her throat (and knocking out two of her teeth in the process).

In the pediatric intensive-care unit, doctors scrambled to figure out what was wrong. A spinal tap and brain scan proved to be negative. Finally, a lab test revealed that Katie’s blood was infected with a strain of the bacteria Streptococcus pneumoniae, or pneumococcus, which was resistant to the antibiotics she had been taking. Pneumococcus is a common cause of childhood ear infection. But if allowed to fester, it can be picked up in the bloodstream and transported to other parts of the body, resulting in serious and even lethal conditions such as meningitis, mastoiditis (an infection of the mastoid bone behind the ear), and bacteremia, the blood infection that led to Katie’s seizure.

Doctors immediately hooked up an IV and began to flood Katie’s veins with a broad spectrum antibiotic until they could get the results of a blood test and determine which drug would be most effective against the resistant bacteria. It turned out to be ceftriaxone, a cephalosporin antibiotic that is prescribed when other drugs don’t do the trick. Within four days, the rogue bacteria was vanquished and Katie was home from the hospital. “There’s no doubt that antibiotics saved Katie’s life,” says Dr. JoAnn Rohyans, her pediatrician at the time. But in an ironic twist, Rohyans points out that antibiotics were probably also to blame for Katie’s life-threatening illness in the first place. In fact, she says, “knowing what I know now, I probably wouldn’t have treated her original infection with an antibiotic. She had signs of early otitis media, but it wasn’t a raging full-blown case.”

Like many children her age, Katie had a history of acute ear infections. And, also like many young children, she had received frequent doses of the antibiotics amoxicillin and bactrim to combat the infections. As a result of this constant course of drugs, her body’s bacteria had most likely begun a natural adaptive process of breeding strains that were impervious to amoxicillin. So when Katie’s most recent ear infection proved resistant to the drugs, her doctor prescribed another antibiotic — in this case, Suprax. Just days before her seizure, Katie had finished up the second of two ten-day courses of the antibiotic.