Our 17 yo was diagnosed with PANDAS eight years ago after sudden onset of obsessive thoughts and discovery of a previously undiagnosed strep infection. He responded dramatically to antibiotics, with the symptoms receding within 24 hours. He had a few flare-ups with strep infections over the next few years, which were also successfully treated with antibiotics, and he also had occasional smaller increases in symptoms with viral infections that remitted on their own. He's had no symptoms for the past 2 1/2 years, but about 3 weeks ago, he had a sudden onset of obsessive thoughts and anxiety that are very distressing to him. His strep test came back negative as did the blood test for antibodies (ASO, I think??), so our pediatrician does not want to put him on antibiotics. He put him on a low dose of clonazepam in the interim, which helps a bit, but it's not a long-term solution. We are trying to get in to see the PANDAS specialist who diagnosed him, but it will be a while, I think.
My question is: Is there any possibility that antibiotics could help if his tests are negative? His symptoms are so much like the symptoms he had with his earlier strep infections, and very different from the blips of anxiety he's had with viral infections, that I'm really afraid we are missing some strep trigger. Our pediatrician is very sympathetic and fairly knowledgeable about PANDAS, so I think he would be open to antibiotic treatment if I could point him to some evidence that it might help.
Thank you in advance for any advice and information!