Antibiotic Question

[pandasstl]

We just finished our 2nd IVIG and Dr. K recommended 500mg Augmentin 1x per day. I have read that not taking this medication 2x per day may not be a good idea. I have the ability to get either 500mg once per day or 250mg 2x per day. I don't know what's worse, having a lower dose but constant in the bloodstream, or having a higher dose and wondering about the possiblity that he is unprotected because the half life is not long. Any ideas?

[MomWithOCDSon]

We just finished our 2nd IVIG and Dr. K recommended 500mg Augmentin 1x per day. I have read that not taking this medication 2x per day may not be a good idea. I have the ability to get either 500mg once per day or 250mg 2x per day. I don't know what's worse, having a lower dose but constant in the bloodstream, or having a higher dose and wondering about the possiblity that he is unprotected because the half life is not long. Any ideas?

 

Because regular Augmentin has such a short half-life (only about 1.3 hours), I think you are probably justifiably concerned. As I understand it, Dr. K. prefers regular Augmentin to its time-released version, Augmentin XR, because the regular formulation has a higher clavulanic acid component, and he feels the clav acid is a key component. But the half-life of clav acid itself is only 1.0 hour, so, either way, if your child is returning to school and/or any kind of regular social life, the risk of re-exposure with once-per-day coverage is a little daunting.

 

I know some parents have successfully lobbied with Dr. K. for a prescription for the XR version or higher doses of the regular Augmentin. Not knowing how old your child is or what he weighs; I suppose if he's young/small enough, 250 mg. twice daily might be sufficient. Generally speaking, though, Augmentin doses tend to run considerably higher than azith doses for similarly-aged individuals, and if Dr. K. felt that 500 mg. once daily was appropriate for your DS, then he could probably handle 500 mg. twice a day.

 

Maybe some others will chime in here with a different experience on this front . . . something more comforting for you. For comparison's sake, my DS began PANDAS treatment at age 12 and about 130 lbs.; he initially took 1,000 mg. Augmentin XR twice daily. The recommended adult dose of Augmentin XR for active infections (sinus, etc.), meanwhile, is actually 2,000 mg., twice a day.

[Worried_Dad]

I'd be concerned about the once-a-day dosage, too. Our ds was also on 500 mg of augmentin once daily (per Dr. K) and kept relapsing. When we lobbied Dr. K to try the "Saving Sammy" dose (1000 mg of XR twice daily), the relapses stopped and he made steady progress.

 

For our son (now 14, about 120 lbs), 500 mg once a day didn't cut it.

 

 

We just finished our 2nd IVIG and Dr. K recommended 500mg Augmentin 1x per day. I have read that not taking this medication 2x per day may not be a good idea. I have the ability to get either 500mg once per day or 250mg 2x per day. I don't know what's worse, having a lower dose but constant in the bloodstream, or having a higher dose and wondering about the possiblity that he is unprotected because the half life is not long. Any ideas?

 

Because regular Augmentin has such a short half-life (only about 1.3 hours), I think you are probably justifiably concerned. As I understand it, Dr. K. prefers regular Augmentin to its time-released version, Augmentin XR, because the regular formulation has a higher clavulanic acid component, and he feels the clav acid is a key component. But the half-life of clav acid itself is only 1.0 hour, so, either way, if your child is returning to school and/or any kind of regular social life, the risk of re-exposure with once-per-day coverage is a little daunting.

 

I know some parents have successfully lobbied with Dr. K. for a prescription for the XR version or higher doses of the regular Augmentin. Not knowing how old your child is or what he weighs; I suppose if he's young/small enough, 250 mg. twice daily might be sufficient. Generally speaking, though, Augmentin doses tend to run considerably higher than azith doses for similarly-aged individuals, and if Dr. K. felt that 500 mg. once daily was appropriate for your DS, then he could probably handle 500 mg. twice a day.

 

Maybe some others will chime in here with a different experience on this front . . . something more comforting for you. For comparison's sake, my DS began PANDAS treatment at age 12 and about 130 lbs.; he initially took 1,000 mg. Augmentin XR twice daily. The recommended adult dose of Augmentin XR for active infections (sinus, etc.), meanwhile, is actually 2,000 mg., twice a day.