So sorry you're going through this, but welcome to the forum.
I'm sure others with more recent experience will chime in, but given your pediatrician's response, I'm wondering if he/she is truly PANDAS-savvy?
--no neither Doctor is savvy in PANDAS , at the moment I need to educate myself with the best antibiotic to use, where would I find that info?
Did the doctor tell you why the switch in antibiotics when the Zithromax -- other than not fully eradicating the strep in 5 days -- seemed to be effective?
--we went to another doctor and that doctor swabbed and prescribed amox with clavulin with the theory that if she swabbed positive that the previous antibiotic did not work
When you say "tested positive for strep" still, after the Zithromax, was that by a throat swab culture, or was it a blood draw that tested for strep antibodies (titers)?
--throat swab
It may be that the amoxicillin (even with the clavulanic acid -- I'm familiar with that being called Augmentin, but maybe yours is a difference synthicyzation of the same components, or you're outside the USA?) -- isn't the right antibiotic for your kid, or for the strain of strep you're dealing with.
--I am in canada and it might be too soon to say if the amoxicillin will work because it has only been 2 days
There are some threads at the top of this PANDAS forum -- pinned threads -- that include some basic background on PANDAS including research papers, etc. It might be worth going through a few of those and sharing them with your doctor.
--can I get a link to those?
But in the end, most of us find that a short-term antibiotic course is insufficient for PANDAs and that a longer-term prescription (usually more than 10 days -- 30+ days) is needed. Unfortunately, depending on your child's immune system and some other factors the researchers are still trying to definitively figure out (genetics, etc.) why some interventions appear most effective for some, and others most effective for others.
--what defines effectiveness? What should I expect if it does work? Are there Doctor's in Ontario canada familiar with this?
I wish you the best!