another antibiotic question...need some opinions

[michiganpandas]

Ok....so I have a prescription of 200mg of azithromycin that I obtained when my son was sick last week....(i talked the pediatrician into it and she is one who is against giving antibiotics as a preventative method)...anyways, my son got better and we have no infections in the house and my daughter is actually doing pretty well at the moment.

 

my questions is...if i gave her the azithromycin is this the same type of treatment that most are on here who are taking azithromycin? (it's the regular stuff given when someone really has a positive infection.....or is the prophaytic form of azithromycin different? (am i making any sense?)

 

would i be doing her more harm than good if she is "ok" right now? I guess I'm just afraid of the beginning of school and I don't want her to get sick now.......if i do give it to her would it be better to give it for the 5 days or could i extend it and give it every 4 days?

 

i know i'm sounding ignorant...it just worries me that i will messing up her system if i give her an antibiotic when she does not have any known bacteria present.

 

thanks for any input!

[Tamistwins]

Hi if you see a pandas specialist they will put your child on an antibiotic that is a high dose or a regular dose that is given to you when your child shows a positive infection. That specialist will most likely keep your child on a full strength until she shows a marked improvement of symptoms. Once your child g-d willing is doing well, then the next step is to lower the dose to a prophylactic. This dose will be used to prevent reinfection. I believe that others who are using prophylactic will double or increase the dose if and when their child seems to have picked up a new infection. I hope that helped I'm sure others will chime in.

Good luck!

[boychildsmom]

Azithromycin (or zithromax) stops bacterial growth. Tablets are 250mg or 500mg. Oral suspension probably comes lower dose. For normal treatment of strep, sinusitis, bronchitis, etc. it's usually prescribed five days @ 250mg w/double dose (500mg) on day one. As prophylactic, it's usually prescribed 30-day refillable @ 250mg. It's used to prevent bacterial infection in people at higher risk of complications. For prevention it can be prescribed daily or 2-4 times weekly. A 200mg or 250mg dose would not provide continual protection for four days (search on "azithromycin half life" for more specific info).

[LNN]

Whether a dose is considered treatment dose or prophylactic dose depends on the child's weight and health status. As Tami pointed out, the term prophylactic is misleading, because some Pandas kids may stay on a "treatment" dose for quite some time with the intention of preventing any flairs. So I wouldn't get too hung up on the terms. Regardless of dosage, the drug is identical. The terms prophylactic vs. treatment don't relate to difference in the composition of the drug being given.

 

I strongly urge you to NOT pulse any antibiotic every 4th day. In terms of germ resistance, this is one of the worst things you could do. Germ resistance develops when germs are exposed to a low dose or short term dose of something that can kill them. If not given in strong enough dosage or long enough duration, the weak germs will be killed but the stronger ones will survive and pass on their resistance ability to their offspring, making that abx useless against that strain of germ. That's why people are urged to complete their abx script even if they start feeling better. You need to make sure the whole colony is destroyed, especially the longer surviving, stronger members. To pulse one dose every 4th day would encourage resistance, not guard against it.

 

Pulsing is sometimes used for some infections of germs with long life cycles, such as lyme, which has a 4-5 week life cycle, or for biofilms, which also seem to have longer life cycles. But it generally isn't used for shorter life cycle bacteria such as strep. Zith roughly stays in the blood stream for 36 hrs, which is why you can get away with only 1 daily dose instead of 2. But I would not pulse in the way you described. If you feel your child should be on some sort of abx for a period of time, I would get an appt with a doctor knowledgeable about Pandas and the treatment strategies that are generally used.

 

Probiotics should always be given when someone is on abx for any period of time, taken 2-3 hours away from an abx dose. This will protect her system far better than an incorrectly timed pulsing plan.

[michiganpandas]

thanks so much....i just feel like i have some liquid gold in my fridge right now and not sure if i should use it....she really is "fine" right now...i would say has bumped up to about 90% better after being at 80% all summer. I guess I was wondering if a quick 5 day does might help with something??? (maybe get rid of something lingering?) or inflammation? i don't know? I guess it also confuses me when people say they take their kids off of antibiotics that they have a hard time??? is that because they immediately get sick again? or were the antibiotics keeping inflammation down?

[dcmom]

michigan- If she is really 90%- that is awesome. IMHO, at that point, she may just need time to heal. What is lingering?

[michiganpandas]

Hi....The ocd is the only thing that is lingering..but, it is better ....i think the zoloft increase helped push her to 90% (along with exposing her (slowly) to to her two main fears...(got that idea from you) and the placebo effect that we are trying due to her doctor throwing that idea onto her (it's not hurting...maybe it's helping? not sure)..... She is (KNOCKING ON WOOD) going to school and enjoying it and when she does worry at home she calms herself down very quickly....the worry times are few and far between.... Since we have not really been on antibiotics at all I just wonder if it might be that extra..also, if she DOES get sick during this first month of school it might set her back more than it would if she had a longer run of success so my thought was to try to use the azith. just for a way to prevent any sickness now.

[dcmom]

HI Michigan- Glad she is doing so well. It sounds like, she might just need more time. With both of my kids, we found that they needed a little ERP post exacerbation to really get to that 100%- but that the ERP was really easy. For them, esp my older, it was more like she was afraid of feeling the fear of ocd again, rather than she was actually ocd.

 

In our house- if it ain't broke, we don't fix it. Meaning at 90% percent, we go into a holding pattern- just doing stuff like: ERP, healthy living (fun, sleep, exercise, eating right, snacking often). I don't change anything.

 

If she does get sick- it could mean nothing- or it could mean another episode. It stinks- and it is almost impossible to fully protect them. We did full strength antibiotics for almost two years, but I feel really happy now to have them on twice weekly. I have come to the conclusion that I can't drive our family insane (and face unintended consequences) of trying to protect them 100% (which I don't think is possible). Instead I focus on having doctors and protocols in place for "if" there is a next time.

 

I would continue with the ERP, watch her, ENJOY her, and figure out with your pandas doc what is right for your family in regard to the antibiotics. (If I was not so chicken, I would have mine off of antibiotics totally, like we did in the summer).