There is no denying that the safe and responsible prescription of antibiotics is critical to modern medicine. But it is also important to reflect on the life-saving role that antibiotics can play in treating other threats to human health when used effectively.
Antibiotics are medicines used to treat a variety of infections or diseases caused by bacteria, such as respiratory infections like pneumonia and whooping cough, urinary tract infections, skin infections and infected wounds. They have helped save millions of lives since they were first introduced in the 1940s and 1950s.
One of the more significant threats to human health is sepsis, a medical emergency that accounts for about 5,000 deaths in Australia each year – far exceeding the national road toll. Each year about 18,000 sepsis cases reach hospital intensive care units across the country and many who survive are left with permanent organ damage or severe disabilities including amputation.
Some people are at higher risk of developing sepsis because they are at higher risk of contracting an infection. These include the very young, the very old, those with chronic illnesses, and those with a weakened or impaired immune system.
What is sepsis?
Sepsis begins with an infection, which can be as simple as an infected cut or sore, a sore throat or urinary tract infection. Sometimes, doctors never learn what the infection was. The body’s normal response is to release immune cells into the bloodstream to try and fight off bacteria, viruses and other causes of infection. But sepsis occurs when the body’s immune system goes into overdrive, creating widespread inflammation that can rapidly lead to tissue damage and organ failure.
In particularly severe cases, sepsis can progress to septic shock, which occurs when a person’s blood pressure reaches dangerously-low levels.
The story of Sunday Mabior
Maurice Blackburn has acted for a number of clients who have suffered catastrophic consequences including death due to sepsis. Sunday Mabior is one of those clients.
Sunday was 18 months’ old when she presented to Perth’s Princess Margaret Hospital with moderate scold burns. Staff performed a swab of her wounds, which tested positive for a bacterial infection, and Sunday went on to develop sepsis. This in turn led to other complications, causing her to suffer multiple heart attacks, mutli-organ failure and a severe brain injury leading to cerebral palsy.
The District Court found that if doctors had recognised the early signs of sepsis and started antibiotic treatment at that time, Sunday would likely have avoided her injuries. This decision was recently upheld on appeal.
Sunday’s story is a timely reminder of the life-changing impact that antibiotic treatment can have when given appropriately. For a condition such as sepsis, the difference between successful and unsuccessful treatment is often a matter of hours, which is why early administration of antibiotics is recognised as one of the most important forms of treatment, if not the most important.
It goes without saying that before sepsis can be successfully treated, it first needs to be detected. Unfortunately, there appears to be a significant gap in the knowledge of most Australians when it comes to sepsis and its treatment. A recent national awareness survey revealed that only 40% of people had heard of sepsis and far fewer were able to name even one of its symptoms.
In its very early stages, symptoms of sepsis can be non-specific and might therefore be mistaken for other illnesses. However, there are a number of tell-tale warning signs which, if recognised, can lead to earlier detection and potentially life-saving antibiotic treatment.
Other than signs of infection, symptoms for adults may include:
- Temperature which is higher or lower than normal
- Lethargy, confusion or disorientation
- Rapid breathing and/or rapid heart rate
- Pale, clammy or mottled skin that is cold to touch
- Severe muscle pain
- Reduced urine output; or,
- Feeling worse than ever before.
For children, the list of symptoms may also include:
- Very drowsy or not responding
- Constant vomiting
- Pale, clammy or mottled skin
- Not eating or drinking
- Seizures or convulsions
- Abnormally cold to the touch
- Not drinking for more than eight hours
- No wet nappies or hasn’t urinated for a day; or,
- Non-blanching rash (that does not fade when it is pressed).
It is important to be aware of these symptoms and seek urgent medical attention if you suspect that you or someone else might have sepsis. Likewise, if you are a concerned parent of an ill child, never be afraid to voice your concerns. It is especially important in the case of children that healthcare providers listen to the concerns expressed by parents.
Sepsis is one condition where better outcomes can be achieved when both patients and health care practitioners can identify the need for early antibiotic intervention.
By recognising the key red flags, you may end up saving a life, which could even be your own.