ear infecting

[aidansmom]

Aidan was first PANDAS and now we are venturing into the Lyme world (IGG positive by Igenex criteria). We started seeing Dr. B. (one time) but then went to see a LLMD (Dr. Jemsek) but have only done an initial exam and lab tests - have not started treatment.

 

Aidan has been on zithro since Dr. B. changed to it from Augmentin almost 2 weeks ago based on the Igenex test. When we made the change I first got all kinds of behavioral symptoms (aggressiveness, loud vocalizations, standing on tables, etc). Then, a few days later he got sick, first raspy throat, then huge amounts of thick nasal drainage. Yesterday we noticed ear drainage so we ended up in the urgent care during the super bowl! (At least it was not busy at that time - got right in.) Doctor saw pus in ear and thought the ear drum had ruptured although he could not see it due to the pus. He prescribed amox.

 

It seems amazing that he got an infection while on zithro. Also, in hindsight I think he had a sinus infection also. Wonder if this is strep.

 

So, now I am wondering if amoxicillan is the best choice since I doubt that the urgent care doctor is versed on PANDAS or Lyme.

 

Does anyone know the difference between augmentin and amoxicillan? I know augmentin has amox plus clavulanate potassium, but when do you prescribe it over amox. alone?

 

The urgent care doctor also prescribed ears drops which have steroids in them. I know that it is a good idea to avoid oral steroids with Lyme but what about in something localized such as the ears?

 

Elizabeth

[sf_mom]

Elizabeth,

 

It is possible to get an ear infection on Azithromycin. I would proceed with BOTH antibiotics prescribed. That is what is more typical of Lyme treatment protocol. I have heard limited use of steroids is o.k. but you never know. When I was put on steroid for two weeks due to rash while pregnant I started to have seizures (I did not know I had Lyme at the time). I would think if you could hold off and give the multiple antibiotics a chance to work it might resolve the ear infection fairly rapidly.

 

When is your follow-up with Dr. J again, is it possible to get appointment moved up so he can start treatment? Again, some of the congestion could be due to herxing but it is best to have an experienced LLMD make the determination.

 

Always remember your child will appear worse on the front end of treatment but that means the antibiotics are working. Our son herx'd for 9 weeks when starting Lyme protocol and he had already seen huge improvements from previous PANDAS treatment so his bacterial load was down. A typical LLMD looks for two days of improvement in the first six weeks of treatment to make the determination treatment is working. Its a long haul.

 

-Wendy

[aidansmom]

Elizabeth,

 

It is possible to get an ear infection on Azithromycin. I would proceed with BOTH antibiotics prescribed. That is what is more typical of Lyme treatment protocol. I have heard limited use of steroids is o.k. but you never know. When I was put on steroid for two weeks due to rash while pregnant I started to have seizures (I did not know I had Lyme at the time). I would think if you could hold off and give the multiple antibiotics a chance to work it might resolve the ear infection fairly rapidly.

 

When is your follow-up with Dr. J again, is it possible to get appointment moved up so he can start treatment? Again, some of the congestion could be due to herxing but it is best to have an experienced LLMD make the determination.

 

Always remember your child will appear worse on the front end of treatment but that means the antibiotics are working. Our son herx'd for 9 weeks when starting Lyme protocol and he had already seen huge improvements from previous PANDAS treatment so his bacterial load was down. A typical LLMD looks for two days of improvement in the first six weeks of treatment to make the determination treatment is working. Its a long haul.

 

-Wendy

Thanks Wendy.

 

So, I am trying to decide if I should give the amox. that the urgent care doc. prescribed or if I should return to the augmentin that Dr. B. had prescribed (still have refills). We stopped the augmentin almost 2 weeks ago before this all started. I know I am not supposed to look for medical advice on this board but I was wondering if anyone knew in general when a doctor prescribes augmentin over amoxicillan.

 

I have sent emails to both Dr. B and and Dr. J and are awaiting their advice particularly Dr. J but being a Monday it might be a while before they get back to me. Our appointment with Dr. J is Feb. 18th.

Elizabeth

[sf_mom]

I do know many children being treated for Lyme are on Augmentin/Azithro combo. All appropriate size dosages. I hope you hear back from one or the other Dr. soon.

 

-Wendy