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IVIG & Antibiotics


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4 replies to this topic

#1 mikey

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Posted 20 July 2010 - 07:19 PM

My son has PANDAS and just did an IVIG @ 1.5grams per kilogram. In your opinion what is the right antibiotic to put your child on to prevent further strep and at what milligram. (Augmentin 500mg once a day or Penecillin VK @ 250mg twice a day)


#2 worried_dad

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Posted 20 July 2010 - 07:35 PM

Abx advice is tricky since this seems to vary so widely from child to child (which one? how much? for how long?). But we also did IVIG @ 1.5g/kg - 3 times - and the "normal" dose of augmentin you mention (500 mg daily) did not protect our PANDAS son from further infections / exacerbations. We had to increase to the "Saving Sammy" dose of augmentin XR (1000 mg twice daily) to finally see sustained progress.

Our son is currently 14 and about 110 lbs. Based on our own painful experience post-IVIG, I'd strongly recommend you ask for a higher dose of abx and stay on it for an extended period to be sure. (We've been on 1000 mg of XR twice daily for 10 months now... and it's the best 10 months our son has had in 3 years!)

Good luck!

#3 peglem

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Posted 20 July 2010 - 07:42 PM

Well, we use 500mg zith every other day, following 3 consecutive days for a loading dose. It seems to be working for us, but my daughter is doing IVIG every 4 weeks.

-Peggy, mom to 19yo PANDAS daughter w/ onset probably in infancy. Manifests w/ severe autism symptoms and currently nonverbal.


#4 eamom

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Posted 20 July 2010 - 08:09 PM

My son has PANDAS and just did an IVIG @ 1.5grams per kilogram. In your opinion what is the right antibiotic to put your child on to prevent further strep and at what milligram. (Augmentin 500mg once a day or Penecillin VK @ 250mg twice a day)


It does seem that many parents find full-strength antibitics regardless of whether IVIG is added to the mix) to be much more effective than lower prophylactic doses.

Also, "bigger gun" antibiotics (eg. Azithromycin, Augmentin XR) definitely seem to be more clinically effective with our kids vs. pen or amoxicillin.

My dd (currently 62 pounds) has been on 250mg/day for over 2 years, although we are thinking of changing to Augmentin. She's had 2 IVIG's. The first in Aug. 09, the second in May 2010.

I also personally believe (just b/c it has a short half-life, and reports of kids getting strep on this forum on 1x daily dosing) that once a day amoxcillin or augmentin isn't a terrbly effective prophylaxis for PANDAS kids. As far as I am concerned, Azith. is the only effective once daily PANDAS antibiotic.

Re. pen...it's really important to give the pen every 12 hours. If you miss a dose your child is unprotected for several days. That info. was from a Swedo lecture.

Edited by EAMom, 20 July 2010 - 08:13 PM.


#5 eamom

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Posted 20 July 2010 - 08:12 PM

Here is an article on Amoxcillin (pen would also count, since it is a "less potent" version of amoxcilllin) failure in strep throat:

http://www.entrepren.../169459644.html




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