Penicillin

[AnitaS]

My 7 year old son has Scarlatina again and was prescribed 2 weeks of penicillin twice a day followed by 5 days of a single dose of penicillin and then azithromycin 80 mg 3X week for 4 weeks. Does this sound right? I just haven't read of anyone using penicillin.

[TexasDad]

Don't know anything about Scarlatina, but Pen VK was prescribed to fight our son's Strep infection and he is on a prophylactic course still today. He has not had a recurrent infection. We're in Dallas, TX.

[thereishope]

In most ped’s offices, penicillin (pen) and amoxicillin (amox) continue to be the first choice of antibiotics given for strep infections. However, most PANDAS parents have learned that they also have high failure rates of eradicating strep so they do not even take the gamble to see if it might work. Time of healing is important in PANDAS and we just don’t have all the time in the world to experiment with things that have high failure rates.

 

Now some PANDAS kids do get better on amox or pen, but it seems that they are in the minority. Then there are some kids that improve on pen or amox at first but then dramatically backslide around the two week mark because it didn’t fully work.

 

Overall, the two antibiotics that seem to have been the most useful for PANDAS kids are Azithromycin and Augmentin (some need high dose Augmentin). Some also go on Omnicef or Keflex. Overall, there is not a cut and dry magic answer for which antibiotic is the best for a child.

 

As for the sequence of antibiotics your child was prescribed, I haven’t heard of that. I would think a they’d start with the stronger antibiotic first. Also, as for the time when it’s a one dose a day of pen…that’s not good. Penicillin needs to be dose twice a day spaced out equally due to its half life.

[AnitaS]

In most ped’s offices, penicillin (pen) and amoxicillin (amox) continue to be the first choice of antibiotics given for strep infections. However, most PANDAS parents have learned that they also have high failure rates of eradicating strep so they do not even take the gamble to see if it might work. Time of healing is important in PANDAS and we just don’t have all the time in the world to experiment with things that have high failure rates.

 

Now some PANDAS kids do get better on amox or pen, but it seems that they are in the minority. Then there are some kids that improve on pen or amox at first but then dramatically backslide around the two week mark because it didn’t fully work.

 

Overall, the two antibiotics that seem to have been the most useful for PANDAS kids are Azithromycin and Augmentin (some need high dose Augmentin). Some also go on Omnicef or Keflex. Overall, there is not a cut and dry magic answer for which antibiotic is the best for a child.

 

As for the sequence of antibiotics your child was prescribed, I haven’t heard of that. I would think a they’d start with the stronger antibiotic first. Also, as for the time when it’s a one dose a day of pen…that’s not good. Penicillin needs to be dose twice a day spaced out equally due to its half life.

[AnitaS]

Thank you we are newly diagnosed so that information is extremely helpful. Our ped said that penicillin is considered the 'gold standard' against strep and that is why she prescribed it. My son is her first PANDAS patient so we are both in new territory here. She is very open and I know will listen to what I have to say. I will take this info back to her. Thanks again.

[thereishope]

Here are some studies you can present to her in regards to penicillin. To date, penicillin has killed strep in the petrie dish, but in the human body, it doesn't. Don't feel odd, bringing articles and studies to give to the doctor. It's less footwork she'll need to do.

 

Amoxicillin Failure in Strep

http://www.entrepreneur.com/tradejournals/article/169459644.html

 

Meta-analysis of Cephalosporin Versus Penicillin Treatment of Group A Strep

http://pediatrics.aappublications.org/cgi/content/abstract/113/4/866

 

Group A Streptococcus and its antibiotic resistance

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2640020/

Edited May 21, 2011 by Vickie

[AmySLP]

My daughter went for 6-7 months on and off low doses of 10 days of penicillian alternated every 3-4 weeks or so with standard doses of AUgmentin-it was during those months of strep that was difficult to erradicate with standard ABX treatments that she developed PANDAS and her symptoms gradually worsened. Finally a different pediatrician saw her and prescribed Clindamycin to fully erradicate an infection that had been there for half a year. I would think treating with the Zithromax first would make more sense.