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eljomom

Zith. dose....too low?

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My dd7 was on Augmentin for a month, now on Zithromax. Dose is 3 cc of 200/5 ml ( a little over 100 mg) a day. Not seeing any improvement. Again, we are hitting this fairly late in the pandas/pitands game, with symptoms likely first starting a few years ago with ocd/hyper....then explosion of tics and sep. anxiety this summer after fever, impetigo, etc....that was 6 months ago. Anyhow, just started abx treatment, but thinking we are likely free of bacteria,virus, etc. and also likely starting to late for abx to have a huge impact at this point. and now I'm just hoping that the abx will give some immuno-mod. or antiinflam. help. Wondering if this dose seems okay? She weighs about 45 pounds. Thanks

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My dd7 was on Augmentin for a month, now on Zithromax. Dose is 3 cc of 200/5 ml ( a little over 100 mg) a day. Not seeing any improvement. Again, we are hitting this fairly late in the pandas/pitands game, with symptoms likely first starting a few years ago with ocd/hyper....then explosion of tics and sep. anxiety this summer after fever, impetigo, etc....that was 6 months ago. Anyhow, just started abx treatment, but thinking we are likely free of bacteria,virus, etc. and also likely starting to late for abx to have a huge impact at this point. and now I'm just hoping that the abx will give some immuno-mod. or antiinflam. help. Wondering if this dose seems okay? She weighs about 45 pounds. Thanks

Seems low to me. I'd be more comfortable w/ 250 mg/day for that weight...maybe cut back later, after a month or so.

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That dose is way too low for strep!

For a 45# child, they should be given 250mg/day to treat strep. She is getting less than half of that dose. Is the presciption for 5 days or for longer?

 

Colleen

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This is likely NOT to treat strep. I believe whole-heartedly that there is NO lurking strep anywhere. She makes good pneumococcal titers, and Dr. T says that means she'd mount a response. No titers. She is PITANDS. So I truly believe this is a (futile?) attempt by Dr. Latimer to try to get something other than abx properties out of the zith, and maybe more of the anti-inflammatory benefits. This is for 1-2 months trial.

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But is she on the zithromax also to prevent her from getting strep, b/c if so, that dose may be too low for that also.

 

 

Coilleen

 

What dose zith do you think would be good just as a prophylaxis?

 

I'm thinking 100 mg daily would be okay. Couldn't it be considered the same as a weekly 750mg or 500mg dose?

 

Thanks

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I think 100mg/day for a 40 something pounder sounds too low. Our dd was on 250mg/day when she was 43 pounds. But, really, you don't really know if the higher dose will be helpful unless you try for a month or two.

 

re prophylactic dosing: bear in mind that PANDAS kids do seem to get strep more than regular kids (that was the conclusion from one of Kurlan's papers), so my thinking is that PANDAS (or pitand) kids don't have a good immune systerm against strep. So, a lower prophylactic dose that might work on a regular person, might not be effective for a PANDAS kids.

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I think 100mg/day for a 40 something pounder sounds too low. Our dd was on 250mg/day when she was 43 pounds. But, really, you don't really know if the higher dose will be helpful unless you try for a month or two.

 

re prophylactic dosing: bear in mind that PANDAS kids do seem to get strep more than regular kids (that was the conclusion from one of Kurlan's papers), so my thinking is that PANDAS (or pitand) kids don't have a good immune systerm against strep. So, a lower prophylactic dose that might work on a regular person, might not be effective for a PANDAS kids.

So do you think a little higher than typical prophylaxis dose would be okay, or do you think just going to full strength is better for preventing strep?

 

I agree there may be something about PANDAS kids catching strep more. Pen vk (as a prophylaxis) was not effective for my daughter...we think all it managed to do was create false negatives. Yet, second to Pen G, it is considered the gold standard for RF...

 

There is no real guideline on using Omnicef as a prophylaxis. I have asked several doctors...what do you use if there is a penicillin allergy?

 

The best answer I got was from an Allergist/Immunologist who said that for kids with chronic ear infections, he will continue on full strength for about a month, then drop to a half dose.

 

That's what Dr. L and We decided to do...Since August she has been on 150mg daily with strep exposure in the classroom...with only very slight increase in OCD and ADD.

 

But I'm not sure casual classroom exposure is enough...now her siblings getting it, that set things in motion the 2nd time. My next step is getting my boys' tonsils out too.

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didn't read other...but too low...

 

my 32lber is on 100mg...afraid to low..might talk about 150 with doc...

 

my 82lb does 250..but i see more at 500mg..then will drop back to 250..after a while...

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So do you think a little higher than typical prophylaxis dose would be okay, or do you think just going to full strength is better for preventing strep?

 

I think this is really unknown...it probalby depends on the kid. But, regardless, many PANDDAS kids seem to do better on full-strength, for whatever unknown reason. Is it just doing a better job at preventing (or eliminating) strep? or is something else at play?

 

There is no real guideline on using Omnicef as a prophylaxis. I have asked several doctors...what do you use if there is a penicillin allergy?

 

Many folks that are allergic to pen use Azith.

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