Madam Thila's health worsened dramatically after a fall at home. It left Thila (whose name has been changed for patient confidentiality reasons) with acute subdural haematoma, or bleeding in the brain, a potentially fatal condition where blood fills the skull cavity, pressing on the brain.
Doctors in her home province of Punjab, India, battled for three months to save the 54-year-old's life, and to stabilise her condition. She underwent repeated surgery, including craniotomies (where a piece of skull is temporarily removed to allow access to the brain) and a tracheotomy (where a hole is made in the windpipe to help get air into the lungs).
Because of her many operations, she had to be given several courses of antibiotics to stave off infection. Unfortunately, Thila was allergic to penicillin and penicillin-like antibiotics, and hence was given a class of antibiotics called carbapenems.
According to Dr Tsang Kay-yan, an infectious diseases specialist at the Hospital Authority Infectious Disease Centre at Princess Margaret Hospital, carbapenems are meant for serious infections that resist all other antibiotics and need to be used with great discretion.
Overuse or inappropriate use of them can lead to the development of bacteria that are resistant to the superdrug. What doesn't kill the bacteria makes them stronger. Part of the need for judicious use of carbapenem, says Tsang, is because no other antibiotics are being developed, and carbapenems are our last defence against severe bacterial infections.
Thila's condition was far from ideal and she remained bedridden. The bleeding had damaged part of her brain, and she was unable to speak or respond much.