Report prophylactic abx dose? in PANS / PANDAS (Lyme included) Posted April 7, 2016 Any abx given only once a week would be very ineffective and IMO would greatly increase the risk of abx resistance. Let's say your DD gets strep again and takes one day of amox. Only a small portion of the strep bacteria would be killed and the remainder would learn how to resistant the mechanisms of amox. That;s why when you have an infection, they tell you to finish the entire course even if you feel better. Any survivors pass on survivor knowledge to their offspring. Once your child is symptom-free, I think the most effective prophylactic schedule is this: Days 1-5 of the month, Azith daily Day 6, 8, 10 (even days) azith (which has a half life of 36 hrs vs. Amox which has a half life of 2? hrs) Then at the start of the next month, do 5 days straight again, then every other day for the rest of the month. The 5 days at the start of the month actually stays effective for the 1st 10 days (which is how a z pak gives you the same coverage as 10 days of amox) and would theoretically kill any simmering infections. Then the every other day gives you sustained coverage for the rest of the month. Doing abx only once a week or even twice a week just seems like begging for any infection to become resistant to that abx. Alternatively, you can read up on herbal antibiotics and use them on an as-needed basis. I've found that giving herbal tinctures at the first suspicion of illness nips things in the bud (I still give the herbs for several days after symptoms subside) and they don't seem to cause the gut damage abx can cause.