Timing of when to take ABX (1 hr before/2 hrs after meals)

[Sheila99]

DD-9 that has high ASO, but asymptomatic finished her 1st 5-day Zithromax this past Wed (6/22), and Friday we finally got her Penicillin in liquid form (cherry flavor) as prophylactic. Dr wants her to take 2x/day (each 1 tsp = 250 mg, so 500 mg total). Ped Dr wants to do this for remainder of the summer and come back for reval, plus to give chance for therapy to work. Good news-her bad thoughts OCD got better under zithromax, not 100%, but much better than we've had in the last 7-weeks. But unless I can solve the sensitive taste issue, this will be 3rd day without the propylactic ABX. I'm trying to make sure we continue the recovery.

 

Instructions mention it is best to take on empty stomach (like 1 hr before eating, or 2 hrs after eating) to better absorbed. Tried it last night and DD spit out most due to yucky taste. Great! And this 60-day bottle has to be refrigerated; with upcoming travel plans without access to refrigeration, I think I will have RX chg to pill form and just crush the pill. SINCE DD VERY SENSITIVE TO TASTE, WHAT HAVE YOU FOUND IS BEST TO GIVE WITH HER CRUSHED PILL? APPLE SAUCE? She's always just had meds in liquid form so dont know how she will take to actually taking pills.

 

Now I am planning what hours of the day I should give this to her, since I had it all planned to give her some probiotics 2 to 3 hrs later per suggestions from forum. During summer break, I can be flexible to a degree when I can give probiotics. Pharmacist last night said I can give probiotics even right after I give the penicillin. Ha? if point of waiting during window (1 hr before/2 hrs after meal) is to ensure best absorption HOW IS IT OK TO GIVE PROBIOTICS RIGHT AFTER TAKING THE MEDS?

 

Lastly, I took her off Kids Calm Multivitamin since June 4th, to see if that was causing the twitching while sleeping. She hasnt been on it since then, and I noticed she's twitching again only while sleeping. I saw a thread somewhere that the twitching ONLY while sleeping seems to be a PANDAs characteristic. Just mentioning it here just in case you got turned off on Kids Calm due to my comment from before.

 

Sorry for being long winded, but this kept me up all night...

[kimballot]

My daughter is also very sensitive to taste. By the time she was 9 she was able to swallow small pills in a tablespoon of applesauce. I found it best to split pills rather than crush pills. Crushed pills change the taste of the applesauce. I purchased a pill splitter and cut the pills into halves or quarters - then put one piece in the middle of a tablespoon of applesauce and said "don't chew - just swallow". You just have to check with the pharmacist to make sure the pills can be spit (time-released pills usually cannot be split).

 

Regarding the timing -

If you switch to pills, they will probably tell you it is OK (and maybe even preferabel) to take the with food - check on that. Breakfast and and dinner might be good for antibiotics. Depending on what time your daugther gets up and eats, you should make this as close to 12 hours apart as you can (ex: 7 am breakfast/ 6 pm dinner).

 

If you need to stay to a time when there is no food in her stomach, then do something like 7 am antibiotics/ 8 am breakfast/ 5 pm dinner/ 7 pm antibiotics /9pm bed and probiotics. I even give my son medicine before he gets out of bed in the morning - which gives him a little time before breakfast.

 

Probiotics are best given at night before bed so they have lots of time to repopulate the gut before you hit it with antibiotics again. Now... if you decide to add in bentonite clay or activated charcoal then you are in for another schedule challenge because they really need to be 2 hours apart from other meds... but you could probably do those after lunch in the summer.

[lfran]

If you can, I would just work really hard to teach her to swallow pills. I taught one son at age 5 and the other at age 7. It takes some practice (the 5 year old practiced with M &Ms, but they were too big for the 7 year old when it was his turn. But..two days after swallowing small pills, the 7 year old can now swallow pretty much any size -- even large vitamins. In my opinion, it's truly worth the effort.

 

My daughter is also very sensitive to taste. By the time she was 9 she was able to swallow small pills in a tablespoon of applesauce. I found it best to split pills rather than crush pills. Crushed pills change the taste of the applesauce. I purchased a pill splitter and cut the pills into halves or quarters - then put one piece in the middle of a tablespoon of applesauce and said "don't chew - just swallow". You just have to check with the pharmacist to make sure the pills can be spit (time-released pills usually cannot be split).

 

Regarding the timing -

If you switch to pills, they will probably tell you it is OK (and maybe even preferabel) to take the with food - check on that. Breakfast and and dinner might be good for antibiotics. Depending on what time your daugther gets up and eats, you should make this as close to 12 hours apart as you can (ex: 7 am breakfast/ 6 pm dinner).

 

If you need to stay to a time when there is no food in her stomach, then do something like 7 am antibiotics/ 8 am breakfast/ 5 pm dinner/ 7 pm antibiotics /9pm bed and probiotics. I even give my son medicine before he gets out of bed in the morning - which gives him a little time before breakfast.

 

Probiotics are best given at night before bed so they have lots of time to repopulate the gut before you hit it with antibiotics again. Now... if you decide to add in bentonite clay or activated charcoal then you are in for another schedule challenge because they really need to be 2 hours apart from other meds... but you could probably do those after lunch in the summer.

[thereishope]

Hi. First, you have a 60 day supply of mixed liquid penicillin? Penicillin is only good for 14 days. We pay for a month of penicillin at a time, but go every 10 days for a freshly mixed bottle. If you do in fact have 60 days of mixed penicillin, you need to talk to the pharmacy.

 

Second,as for refrigeration, when we travelled, we put our bottle in a mini cooler like you used for baby bottle and an ice pack. A the hotel we refilled a zip lock with ice from the ice machine and put that in the cooler.We also put the penicillin bottle in a ziplock bag just in case anything leaked.

 

Our regimin is (keep in mind he was out of the house for school from 8:45 am till 4:00pm):

 

Between 8:00 and 8:30AM pen vk, multivitamin, allegy med if needed

after dinner probiotic, dinner around 4:30-5pm (not ideal time after food, but that's the time we had available)

Between 8:00 and 8:30 pm pen vk, Omega 3, allergy med if needed

 

My son liked the bubble gum flavored pen vk the best.

[Sheila99]

Thank you all so much for the advise. I will digest all of it and get it going...Sheila ~

[P_Mom]

My boys were 4 and 7 when they were put on prophylactic penicillin. I had never attempted pills with them before, but, the thought of the hassel with the liquid version prompted me to ask for pills without even trying anything with them beforehand.....I was determined, but, on my side was their huge dislike for the liquid taste....as you also have in your favor. I picked them up, (the Pen Vk pills are tiny), told them to to put them in their mouths and take a big drink and swallow the pill with the water. (otherwise they would have to take the yucky liquid) Viola! Down the hatch for both of them, first try....no problems....remember...my one son was only 4. They can now swallow horse pills if needed....which is good because the Augmentin is bigger...the 500 mg even more so. I couldn't imagine lugging around the liquid....and the taste really is yucky! Give it a shot.... maybe 'sometimes' the parents are more afraid to give their kids pills than the kids are of swallowing them....sometimes.

 

Oh, penicillin is best given on an empty stomach....like it says. I gave in the am immediately upon awakening.....then, just before bed and I would "close the kitchen" 2 hours before bed. (we are not on that med anymore, so, those days are over) Probiotics 1 hour before, or 2 hours after eating. Sorry if I repeated what others already said....I am bored today.

[Sheila99]

Hi there - I was thinking of getting the Pearls probiotic (as recommended by Vickie). What others are there that you moms are using...someone mentioned to make sure it didnt have strep strain on it otherwise the efforts from the ABX is nil. Thanks -

[P_Mom]

We use...after many trials and errors.....HLC high potency capsules from Pharmax...we get them online. (no strep strain) Anyway.....if your child doesn't swallow pills, they have a powder form or you can open the capsules and the stuff completely dissolves in liquid....no girt, bad taste. etc. You don't even know it is in there....except if you get the powder form...it is apricot flavored...tastes good. Pearls...FOR US...I didn't feel had enough "stuff" in it and for some reason I prefer refrigerated probiotics over shelf stored........again, this is just me.

Edited June 25, 2011 by P.Mom

[thereishope]

I suggested Pearls because of their size. They are very tiny. They also may be a way to get you daughter comfortable with swallowing pills. That was the first pill my non-PANDAS son learned to swallow.