Dosing of AugmentinXR

[purple66p]

My son completed a round of Augmentin (regular) 4000 mg/day divided into two doses on Friday for an ear infection. We saw some improvement in his symptoms during that time, but yesterday was sort of a bad day. Our family doctor is willing to extend the antibiotics--she's great & has been reading all the info I sent her--and asked for my recommendation for dosing. Would you guys share what doses their kids are on? I know it will be different for every kid, but is 4000 mg/day too much long-term? I understand the "Saving Sammy" does is 2000 mg/day. Also, it has been suggested that Augmentin XR might be a better bet long-term. My son is 13 and 120 pounds. Thanks!

[MomWithOCDSon]

Our DS is also 13 and took 2,000 mg. Augmentin XR for one year; 4 weeks ago, we decided to try stepping him down to just 1,000 mg. of XR, and it has been going well. I credit the long-term use of XR for bringing our DS and our family back to some semblance of "normal."

Edited October 11, 2010 by MomWithOCDSon

[Worried_Dad]

Our ds (14) has also been on the "Saving Sammy" dose of augmentin XR, 1000 mg twice daily, for almost a year now. He's probably between 115 and 120 lbs at this point. It's been working very well for him to date: he's back in school after a 3-year absence.

 

Mom with OCD Son - we've been trying to figure out when to try a lower dose, too, but are scared to death to try it. (Rest of family still has unexplained high ASO, despite a month of clindamycin.) Please keep us posted on how things go with your ds on the lower dose. We hope to follow in your footsteps!

 

 

Our DS is also 13 and took 2,000 mg. Augmentin XR for one year; 4 weeks ago, we decided to try stepping him down to just 1,000 mg. of XR, and it has been going well. I credit the long-term use of XR for bringing our DS and our family back to some semblance of "normal."

[NancyD]

My DD14 has been taking 1000 mg bid Augmentin XR since April (following HD IVIg in mid-March) and is doing well with it. No plans to change dosage any time soon.

[Joan Pandas Mom]

How long after starting the higher dose of Augmentin did it take to see results?

[MomWithOCDSon]

How long after starting the higher dose of Augmentin did it take to see results?

 

In our case, it was literally a matter of days, but we were going from no medical treatment at all to our first try at abx.

 

Throughout the year, we've had plateaus, fall-backs and gains, but the overall trajectory has been positive. Over time, we had to learn not to panic about some of the fall-backs (saw-tooths) and focus on the overall gains. We're still not 100%, but after probably 10+ years of PANDAs and 7 years of OCD, we're prepared for a "new normal."

[smartyjones]

Our DS is also 13 and took 2,000 mg. Augmentin XR for one year; 4 weeks ago, we decided to try stepping him down to just 1,000 mg. of XR, and it has been going well. I credit the long-term use of XR for bringing our DS and our family back to some semblance of "normal."

 

so mom -- am i correct in understanding your first step down was cutting the dose in half?

[MomWithOCDSon]

Our DS is also 13 and took 2,000 mg. Augmentin XR for one year; 4 weeks ago, we decided to try stepping him down to just 1,000 mg. of XR, and it has been going well. I credit the long-term use of XR for bringing our DS and our family back to some semblance of "normal."

 

so mom -- am i correct in understanding your first step down was cutting the dose in half?

 

After the full year on the 2,000 mg., yes.

 

We had tried cutting back a few times months ago, shortly after we began the whole PANDAS thing. He would be on full dose for a month or two, we would sense a plateau, and try cutting back. But his regressions back then were always so dramatic and "full-force" that we felt compelled to put him back to full dose again. So we let the full dose ride uninterrupted for the last 7+ months, until we'd hit the one-year mark.

 

Now we give him 1,000 mg. XR in the morning, before school, and that's it. We're into Week 4 now of the reduced dosage . . . further than we ever made it with a reduced dose in the early months of treatment.

[purple66p]

Thanks everyone for your advise on dosing. Our doc called in 1000 mg 2x/day & last night we started back up with the antibiotic. This time with the XR version. She called in 3 refills, so 4 months total. Hopefully that will be enough time to see some great improvements and we can extend if needed! His problems have been going on for 6+ years and we've only recently started treatment, but I'm determined to remain optimistic. Thanks for the warning that there will likely be some ups and downs, but we can hope for an overall upward trend.

 

He's on a lot of meds right now, but I think we can start gradually bringing everything else down and see how he does with the antibiotic, although I think we'll keep him on a small dose of Abilify for now. My understanding from Dr. Cunningham's work is that Pandas screws up the dopamine system, and Abilify is supposed to level out dopamine, supplying more where needed and less where needed. As I've mentioned before, he had immediate and dramatic improvement when we first started Abilify, but it seemed to diminish with time. However, I'm afraid to take him off completely because last time we did that was a total disaster! Thanks again!

[MSmom]

875 mg of regular Augmentin, twice a day. Does this like enough for a 155 lb sixteen year old girl?

[MomWithOCDSon]

875 mg of regular Augmentin, twice a day. Does this like enough for a 155 lb sixteen year old girl?

 

Pam --

 

Is this dose intended as a response to 1) a current infection, 2) an ongoing PANDAS treatment or 3) prophylactic?

 

I think if you look up 875 mg. Augmentin, 2x daily, you'll find it is probably adequate for treating certain infections, including strep. There's a lot of anecdotal information out there, though, that suggests that perhaps either the XR (time-related) formulation of Augmentin or Zithromax are more effective at treating PANDAS. It could be because regular Augmentin's half-life is quite short, whereas Zith's half-life is very long (something like 73 hours, if I recall correctly), and the time-released formulation of Augmentin (XR) would theoretically leave the drug active in the body longer than the regular form, also.

 

On the other hand, I understand that some find the regular Augmentin to be more effective against PANDAS, perhaps because it actually has a higher clavulanic acid component than the XR version.

 

Lots of bodies of thought, unfortunately, and none of them necessarily applicable in every case; all our kids seems to respond differently to medications. You might search here on the forum for "XR" or "zith" or "clavulanic acid" or similar terms to get a broader perspective on the topic.

 

Good luck!

[MSmom]

Nancy,

The dose is intended as both ongoing PANDAS treatment and prophylactic I believe. (She was just switched from Zithromax to Augmentin----She was on Zithromax for a couple of months as both a treatment for mycoplasma and prophylactic for strep.)

 

My daughter's dose sounds a bit lower than I am seeing on the forum. And I did wonder about the XR vs. the regular Augmentin.

 

Thanks for the food for thought. I guess I need to bring these things up the next time I speak to the doctor.

 

875 mg of regular Augmentin, twice a day. Does this like enough for a 155 lb sixteen year old girl?

 

Pam --

 

Is this dose intended as a response to 1) a current infection, 2) an ongoing PANDAS treatment or 3) prophylactic?

 

I think if you look up 875 mg. Augmentin, 2x daily, you'll find it is probably adequate for treating certain infections, including strep. There's a lot of anecdotal information out there, though, that suggests that perhaps either the XR (time-related) formulation of Augmentin or Zithromax are more effective at treating PANDAS. It could be because regular Augmentin's half-life is quite short, whereas Zith's half-life is very long (something like 73 hours, if I recall correctly), and the time-released formulation of Augmentin (XR) would theoretically leave the drug active in the body longer than the regular form, also.

 

On the other hand, I understand that some find the regular Augmentin to be more effective against PANDAS, perhaps because it actually has a higher clavulanic acid component than the XR version.

 

Lots of bodies of thought, unfortunately, and none of them necessarily applicable in every case; all our kids seems to respond differently to medications. You might search here on the forum for "XR" or "zith" or "clavulanic acid" or similar terms to get a broader perspective on the topic.

 

Good luck!

[MomofJacob]

My son who weighs 43 lbs and is 8 was started on 250mg of augmentin 3x daily. He was on zithromax prior (started August). Does anyone have any research on dosages for children with pandas? our son was symptomatic in May 2010 but we have seen quite a reduction in tics since being on the abx. However, I would like to see more awareness and less emotional liability. Any suggestions or comments are welcomed. Thanks.

 

Nancy,

The dose is intended as both ongoing PANDAS treatment and prophylactic I believe. (She was just switched from Zithromax to Augmentin----She was on Zithromax for a couple of months as both a treatment for mycoplasma and prophylactic for strep.)

 

My daughter's dose sounds a bit lower than I am seeing on the forum. And I did wonder about the XR vs. the regular Augmentin.

 

Thanks for the food for thought. I guess I need to bring these things up the next time I speak to the doctor.

 

875 mg of regular Augmentin, twice a day. Does this like enough for a 155 lb sixteen year old girl?

 

Pam --

 

Is this dose intended as a response to 1) a current infection, 2) an ongoing PANDAS treatment or 3) prophylactic?

 

I think if you look up 875 mg. Augmentin, 2x daily, you'll find it is probably adequate for treating certain infections, including strep. There's a lot of anecdotal information out there, though, that suggests that perhaps either the XR (time-related) formulation of Augmentin or Zithromax are more effective at treating PANDAS. It could be because regular Augmentin's half-life is quite short, whereas Zith's half-life is very long (something like 73 hours, if I recall correctly), and the time-released formulation of Augmentin (XR) would theoretically leave the drug active in the body longer than the regular form, also.

 

On the other hand, I understand that some find the regular Augmentin to be more effective against PANDAS, perhaps because it actually has a higher clavulanic acid component than the XR version.

 

Lots of bodies of thought, unfortunately, and none of them necessarily applicable in every case; all our kids seems to respond differently to medications. You might search here on the forum for "XR" or "zith" or "clavulanic acid" or similar terms to get a broader perspective on the topic.

 

Good luck!

[MomWithOCDSon]

My son who weighs 43 lbs and is 8 was started on 250mg of augmentin 3x daily. He was on zithromax prior (started August). Does anyone have any research on dosages for children with pandas? our son was symptomatic in May 2010 but we have seen quite a reduction in tics since being on the abx. However, I would like to see more awareness and less emotional liability. Any suggestions or comments are welcomed. Thanks.

 

 

Mom --

 

Most peer reviewed papers/research I've seen have to do with effectiveness and dosages of abx for other, sometimes related, conditions such as rheumatic fever. I think Swedo and her team published on the effectiveness of penicillin during her initial PANDAS research, but I'm not aware of any more "modern" or "cutting edge" studies reflecting the use of today's most popular/anecdotally effective abx. What IS out there, however, are articles regarding some of the other properties various classes of abx bring to the table, such as the fact that macrolide abx (such as azith) appear to have anti-inflammatory and immune modulatory properties, and b-lactams (such as augmentin) appear to have a glutamate modulating component which assists PANDAS kids who represent with OCD behaviors.

 

Overall, it seems to be more of an anecdotal history of response or lack thereof. If you use some of those search terms suggested earlier in the thread, you should come up with some links to papers on the topics noted above. Or feel free to PM me with an email address and I'll gladly forward you whatever I have. My library's been growing substantially for the last year or so!