Can I give penicillin for a long time to my 6 year old son?
Q: My son is now 6 years 4 months old, healthy and extremely playful. I am describing in short his present problem and the relevant course of treatment. A few months back he developed fever. We went to the doctor who advised Taxone O 100 DT, Nimulid MD and crocin syrup. The next day he developed pain in the calf muscles and was not able to stand or walk. Blood ESR and ASO titre were suggested. ASO was negative and ESR was 70 mms for the first hour. The doctor did not tell anything specifically. He suggested to continue Taxone and bed rest. Disprin (1/2 tab three times a day) was also suggested. Later, the pain had gone and there was no fever. The child was apparently normal. We went to the doctor. Another ESR was done, the readings were the same (70 mms first hour). Kaypen 250 and Disprin, Celin 50 were suggested to continue. With doctors permission we went out of the town for 10 days. My son was ok and perfectly normal. Meanwhile we consulted another physician cum cardiologist who told us not to worry the least and doubted the raised value of ESR and told us that the readings might have been wrong. So, again ESR was done. This time it was 09 mms, in one hour. The doctor suggested to continue Kaypen 250 and Disprin (1/2 tab two times daily) and Celin 50 too. My son is now perfectly ok with no apparent pain. The medicines are still taken by him. Let me also tell you that for more than a year, in the evenings, my son told us that his knee joints were aching. The doctor related this with the tips of bone growing and said that it was normal. I eagerly seek your comments on this. The problem itself and how much should we be concerned with this? Is this a serious matter? Can Kaypen or Disprin be continued for long time safely?
A:It seems from the description of the investigations and the drugs used for treatment, that the treating doctor has diagnosed that your son is suffering from Acute rheumatic fever. However, the symptoms and the results of investigations do not support that diagnosis. ESR can be elevated in a number of conditions including rheumatic fever. The description of pain in the calf muscles is not typical of arthritis. It is true that many infants experience vague pains especially over knee joints, loosely termed as growing pains. The negative ASO titre usually rules out the diagnosis of rheumatic fever. It could have been reconfirmed by a repeat test or a throat swab culture for the microbe, beta-haemolytic streptococcus. I am against the continued use of penicillin and aspirin in very young children who are asymptomatic and do not have clear features of acute rheumatic fever.