Can someone direct me to research on not using penicillin to treat an

[MMWG]

I have read several summary posts or white papers saying that augmentin or cephalaxin are more effective to treat a pandas episode. we have traditionally been given cephalaxin because we thought we had a penicillin allergy. when we went for the preventative antibiotics, our doc was willing to do it but wanted to try penicillin since it is so narrow spectrum. now we are on a higher dose to treat an episode, but he kept us on the penicillin and didn't want to do the cephalaxin. it's not working. i don't want to be disrespectful, and he probably won't respond to "i saw on the parent board for pandas that penicillin doesn't work well" so I am hoping someone can send me to the cite for a few articles that will validate the use of the others instead of the penicillin. Thanks!

[EAMom]

I have read several summary posts or white papers saying that augmentin or cephalaxin are more effective to treat a pandas episode. we have traditionally been given cephalaxin because we thought we had a penicillin allergy. when we went for the preventative antibiotics, our doc was willing to do it but wanted to try penicillin since it is so narrow spectrum. now we are on a higher dose to treat an episode, but he kept us on the penicillin and didn't want to do the cephalaxin. it's not working. i don't want to be disrespectful, and he probably won't respond to "i saw on the parent board for pandas that penicillin doesn't work well" so I am hoping someone can send me to the cite for a few articles that will validate the use of the others instead of the penicillin. Thanks!

 

Here's one:

http://www.urmc.rochester.edu/news/story/index.cfm?id=981

 

Another popular antibiotic for PANDAS kids is Azithromycin. Although some docs in the East Coast are reluctant to rx due to strains of resistant strep (in the East Coast), some parents find this drug works very well for them. Unlike Amoxicillin, Pen, and Cephalexin, Azith. is effective against Mycoplasma (another PANS trigger) and is immune modulating and anti-inflammatory.

 

Also, Azithromycin (and to a lesser extent Cephalexin) are better at killing intracelllular strep than Pen. Here's the article:

http://cid.oxfordjournals.org/content/43/11/1398.full

 

Sometimes it is a matter of trial and error to see what antibiotic works best in an individual child, but Azith., Augmentin, and cephalosporins (like Cephalexin) are all reasonable choices for a PANDAS child when Amoxcillin or Pen doesn't seem to be working.

Edited September 19, 2011 by EAMom

[thereishope]

Here's another for your aresnal:)

 

Meta-analysis of Cephalosporin Versus Penicillin Treatment of Group A Streptococcal Tonsillopharyngitis in Children

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

 

 

Was your child on prophylactic pen vk? My ped switched my son from prophylactic pen vk to a full dose cephalosporin when strep was in our house. After the treatment dose, we went back to proph pen vk. She said it was best to switch him in the event he did contract it, he should be on a different family of antibiotics. She wanted to err on the side of caution.

Edited September 19, 2011 by Vickie

[MMWG]

Here's another for your aresnal:)

 

Meta-analysis of Cephalosporin Versus Penicillin Treatment of Group A Streptococcal Tonsillopharyngitis in Children

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

 

 

Was your child on prophylactic pen vk? My ped switched my son from prophylactic pen vk to a full dose cephalosporin when strep was in our house. After the treatment dose, we went back to proph pen vk. She said it was best to switch him in the event he did contract it, he should be on a different family of antibiotics. She wanted to err on the side of caution.

 

Yes, he was on prophylactic amoxicillin--now he's on amoxicillin + something else (an enzyme), much higher dose. I am wondering if there is anything swedo or murphy wrote that talks about which antibiotics are best to treat pandas exacerbations? My doc was all about the cephalexin when we thought he was allergic to penicillin, now we know he's not and so the doc really is a fan of the penicillin now, which is not helping. I think he's actually a bit worse, tic wise and emotionality wise.

 

Sigh.

[MMWG]

I have read several summary posts or white papers saying that augmentin or cephalaxin are more effective to treat a pandas episode. we have traditionally been given cephalaxin because we thought we had a penicillin allergy. when we went for the preventative antibiotics, our doc was willing to do it but wanted to try penicillin since it is so narrow spectrum. now we are on a higher dose to treat an episode, but he kept us on the penicillin and didn't want to do the cephalaxin. it's not working. i don't want to be disrespectful, and he probably won't respond to "i saw on the parent board for pandas that penicillin doesn't work well" so I am hoping someone can send me to the cite for a few articles that will validate the use of the others instead of the penicillin. Thanks!

 

Okay, so this is where I pause and realize how good of a pediatrician we really do have. I was assuming our doc had just upped our penicillin, though he did mention to me it was "peniciliin plus", containing an enzyme that would help deliver the medicine. I was reading Saving Sammy tonight and got to the chapter where they talked about Augmentin--how it is really pencillin plus clavulanic acid. I trotted to the fridge to see just what our "plus" was...and lo and behold, it is clavulanic acid. Therefore, he has him on Augmentin, it's just not called augmentin.

 

It still may not work for him, right now he is soooooo emotional it is unreal. It breaks my heart to see him so upset over the smallest things, and it is driving my husband nuts. I'll stick it out til the prescription is gone and then check in with my report.

[EAMom]

Having a high enough dose of Augmentin(or Azith) is important too. For example, Sammy was on 1000mg 2x daily.

[eljomom]

Augmentin for one month made us worse. low dose zithromax didn't do much, but not worse. keflex after strep helped a tad for a couple weeks, and now tics are worse than they have ever been.

[MMWG]

Having a high enough dose of Augmentin(or Azith) is important too. For example, Sammy was on 1000mg 2x daily.

 

Yes, we are on 400 mg 2 X daily, and the kid only weighs 55 lbs. I still think it is making him more emotional and his tics are the same if not worse. However, I am thinking I will talk to the doc about going more abx rather than the prescription for the other anxiety med. Don't know for sure.

[MMWG]

Augmentin for one month made us worse. low dose zithromax didn't do much, but not worse. keflex after strep helped a tad for a couple weeks, and now tics are worse than they have ever been.

 

Kephlex has been the best for us, not sure why he doesn't want to use again now. However, i do remember the tic issue was the hardest to get rid of...last time we saw it it took many months, and one day it was gone. It's like pulling him out of quicksand. The emotionality is so tough to watch--we spent so long getting him to a place where he was mature enough not to cry whenever something didn't go his way, and now we are back to square one on that. Now there is even more of an anxiety bent to it--if we reprimand him, he is sure no one loves him and everyone is mad at him Poor guy.

[Wickedmaineah]

I have read several summary posts or white papers saying that augmentin or cephalaxin are more effective to treat a pandas episode. we have traditionally been given cephalaxin because we thought we had a penicillin allergy. when we went for the preventative antibiotics, our doc was willing to do it but wanted to try penicillin since it is so narrow spectrum. now we are on a higher dose to treat an episode, but he kept us on the penicillin and didn't want to do the cephalaxin. it's not working. i don't want to be disrespectful, and he probably won't respond to "i saw on the parent board for pandas that penicillin doesn't work well" so I am hoping someone can send me to the cite for a few articles that will validate the use of the others instead of the penicillin. Thanks!

 

Here's one:

http://www.urmc.rochester.edu/news/story/index.cfm?id=981

 

Another popular antibiotic for PANDAS kids is Azithromycin. Although some docs in the East Coast are reluctant to rx due to strains of resistant strep (in the East Coast), some parents find this drug works very well for them. Unlike Amoxicillin, Pen, and Cephalexin, Azith. is effective against Mycoplasma (another PANS trigger) and is immune modulating and anti-inflammatory.

 

Also, Azithromycin (and to a lesser extent Cephalexin) are better at killing intracelllular strep than Pen. Here's the article:

http://cid.oxfordjournals.org/content/43/11/1398.full

 

Sometimes it is a matter of trial and error to see what antibiotic works best in an individual child, but Azith., Augmentin, and cephalosporins (like Cephalexin) are all reasonable choices for a PANDAS child when Amoxcillin or Pen doesn't seem to be working.

 

 

Guess we are one of the lucky ones. We are located as far East as you can go in the US (Maine) and our son is on 6 months of Zith as a preventitive. Started it the first week of school and thank goodness because by the second week of school strep was already running through. He had someone in his classroom, sitting at the same table, with strep and he is still strep free!

[thereishope]

Do you know if you're dealing with strep? If it's something additional like Mycoplasma, perhaps the keflex was doing a better job in keeping that in check.