Strep while on ABX?

[Bio and adopt]

My 15 YO PANDAS son is on his second 30 day course of Biaxin with 10 days of Aug XR in between. So he has been on high dose ABX for about two months now. He began complaining of a sore throat two days ago and says it feels worse now. Should I be worried about strep? He has not had strep much since he had tonsils removed 7 years ago. Before ABX his strep titers were normal but Myco P was high. His PANDAS does not seem to be any worse the last few days. Can allergies cause a throat to very sore? He did start using Flonase a few days ago for what we think may be nasal allergies, could Flonase cause very sore throat?

Thanks for advice

Melissa

[Kayanne]

It's still possible to get strep while on antibiotics...probably a lot less likely, but still possible. So, if you want to be on the safe side, get his throat swabbed and then you can ask for a 72 hour backup culture.

 

I do think that the nasal sprays can cause a sore throat--allergies can too, especially if the throat itches and he sucks on the back of it--torture!

 

http://www.drugs.com/sfx/flonase-side-effects.html

 

I've always taken the "better safe than sorry" approach after my daughter's PANDAS...but I also have a good ped practice that doesn't hesitate to check for strep if I ask.

 

But, you need to go with your mommy gut, and if there are no PANDAS behaviors getting worse, then you need to weigh that into your decision.

 

Good Luck!

[Johnsmom]

My ds complained of a sore throat when he started augmentin. Turns out it was reflux. His throat looked a little red but no strep on rapid or culture.

[matis_mom]

My 15 YO PANDAS son is on his second 30 day course of Biaxin with 10 days of Aug XR in between. So he has been on high dose ABX for about two months now. He began complaining of a sore throat two days ago and says it feels worse now. Should I be worried about strep? He has not had strep much since he had tonsils removed 7 years ago. Before ABX his strep titers were normal but Myco P was high. His PANDAS does not seem to be any worse the last few days. Can allergies cause a throat to very sore? He did start using Flonase a few days ago for what we think may be nasal allergies, could Flonase cause very sore throat?

Thanks for advice

Melissa

 

Melissa,

It could be viral, allergies, or Strep! It's hard to know without getting it checked out. My son got an ear infection while on XR (but coincidentaly, we were trying to switch to Zithromax, I saw him backsliding, changed back to XR, but a couple of days letter he had an ear infection). I wound say if he is not any worse PANDAS-wise, it's probably not strep, but just in case I would take him in. Our pediatrician is used to our weekly visit by now!!! This week I was in there Thurs, Fri, AND Sat (finally got her to treat everyone again, yeah!)

[momaine]

I believe my dd got a sinus infection while on 500mg Azith. She said she had thick phlegm running down the back of her throat and her PANDAS symptoms were ramping up. Started her back on Augmentin (along with the Azith) and in 24 hours she felt MUCH better and her PANDAS symptoms stopped spiraling downward and have now (a week later) finally begin to improve again. Scared me there for a bit. Am thankful we figured out what was wrong so quickly and got her back on Augmentin.

[airial95]

My son got strep twice while on azith. So yes - it's possible - I'd have him checked out to be safe. Our pediatrician explained it to us by saying it was an azith-resistant strain of the strep that he caught. We have since switched to Omincef.

 

But - this weekend, our son complained of a sore throat (first time he's ever complained) so to be safe, we were off to After Hours Pediatrics. (where I encounted a less than PANDAS friendly nurse practitioner - but that's another story). Turned out it was viral tonsilitis. So it could be something else.

 

I agree with Kayanne - if my kid says his throat is sore - we're off to get looked at.

 

Ironically, my son is young, and EVERY time he says to me "Mommy, I need to go see Dr. Friedmeyer" even if he looks seemingly healthy and hasn't had any PANDAS symptoms yet - it turns out for sure something was up. It's like he's feeling something trigger in his brain but can't quite describe it to us. Thank heaven he likes to go to his pediatrician!!!

[Bio and adopt]

Thanks for the responses. He does have strep. Pediatrician put him on Keflex and said to also continue with the Biaxin. Is the Keflex a good choice?

[matis_mom]

Thanks for the responses. He does have strep. Pediatrician put him on Keflex and said to also continue with the Biaxin. Is the Keflex a good choice?

Good job at catching it! Hope the fallout is mild. I've found whenever DS is on two abx, he seems to do his best. And yes, I think Keflex is a good choice. And, I just have to say this, did you check other family members??? Keep us posted.

[matis_mom]

I believe my dd got a sinus infection while on 500mg Azith. She said she had thick phlegm running down the back of her throat and her PANDAS symptoms were ramping up. Started her back on Augmentin (along with the Azith) and in 24 hours she felt MUCH better and her PANDAS symptoms stopped spiraling downward and have now (a week later) finally begin to improve again. Scared me there for a bit. Am thankful we figured out what was wrong so quickly and got her back on Augmentin.

Why is that? We had the same experience! I guess they just NNNNNEEEEED that Augmentin, huh?

[Fixit]

My 15 YO PANDAS son is on his second 30 day course of Biaxin with 10 days of Aug XR in between. So he has been on high dose ABX for about two months now. He began complaining of a sore throat two days ago and says it feels worse now. Should I be worried about strep? He has not had strep much since he had tonsils removed 7 years ago. Before ABX his strep titers were normal but Myco P was high. His PANDAS does not seem to be any worse the last few days. Can allergies cause a throat to very sore? He did start using Flonase a few days ago for what we think may be nasal allergies, could Flonase cause very sore throat?

Thanks for advice

Melissa

 

i am getting concerned about the long term theory with abx and strep still coming through...

the problem i am haveing..and so a word of caution is yeast...

ds had tonsils out friday and last night i saw thrush...so we are going to ent this afternoon...

and it seems to be an endless circle ...to the point we cant be on any abx w/o diflucan.....

this cannot be good..

in past ds would remit on 10-14 day couse of abx and get 3-5(5 being the longest) of remission...

if you are getting breakthrough every 3-5 months anyway...why not give the gut a break....

 

i would like to hear thoughts as i am very concerned that i can't break this cycle for ds ...

and i am wondering if the gut may be the actual(only) issue at this time!!!!

[wornoutmom]

Can I ask how the strep was caught? Rapid test? Culture? I may be wrong but it seems like everyone is always saying the tests often come back negative if you are already on abx. So wow - was that some strong strep, or just abx resistant?

[Bio and adopt]

Yes it was caught on rapid. This surprised me because in the past he would sometimes be neg rapid and pos culture. I asked ped how my son could get strep while on abx he said Biaxin is not a great abx for strep. We are using biaixin to treat Myco. Although my son had 10 days of AugXR that he finished about two weeks ago. We were using that just to see if it would help with the tics more than the Biaxin was. Ds has not had strep that we know of in a couple of years and at last check in August titers were normal. We believe Myco has been more of the problem over the last year. He did a 5 day steriod burst with the Aug XR, could that have weakened his immunity?

 

When he started complaining of sore throat we did not notice any increase in PANDAS symptoms other than snorting tic increased. I wonder if it was because he was already on abx. PANDAS is so temperamental I never know what to expect. One day you think you have it figured out and the next your child surprises you. Each exacerbation is a mystery.