Rotating Antibiotics and Tests

[hugs2day]

My ds6 had been on Azithro for 10 months on a daily regular dose any effort to cut back results in symptoms ramping up. I'm worried the abx is going to stop being as effective. My question is, should the dr. be rotating antibiotics? There has been several occasions over the past 10 months in which my son developed impetigo while on Azithro and the doc added keflex. My son responded really well when on both antibiotics.

 

Also what tests do I ask for to look for coinfections? I would appreciate anyone who could direct me to get more diagnostic testing because it concerns me my son did better on two antibiotics.

[LNN]

When you say co-infections, are you asking about lyme or other things? There's the Igenex basic lyme panel for about $200 (you pay up front but can submit a claim to insurance and may get reimbursed, depending on your coverage). There's a new lyme test that's just come out from another lab that can culture spirochetes - giving you direct, undeniable evidence of lyme, much like a strep throat culture - that's about $500 (see the lyme forum or PM me for details). You can test for bartonella - a tick co-infection that's known for it's OCD symptoms, that can be tested for by Specialty Labs - a division of Quest - that's covered by most insurance. But like all lyme tests, it's not highly reliable because it's looking for antibodies, not for direct evidence. You can also test for mycoplasma with a general lab.

 

The other thing you can test for is markers that immune system is activated. C3d immune complexes show a general activation (Dr B uses this test a lot) but it doesn't tell you what's causing any elevation. C3a and C4a immune complexes are associated with lyme and mold but again, aren't definitive. But they can be done by any lab and are generally covered by insurance.

 

If your child does better with combo abx, that isn't something to dismiss. But ordering tests is only one part of the puzzle. Collaborating with a doctor who understands what to do with the results, what follow-up tests to order, what abx combos work best for various infections, what non-abx herbs might help, what detox supplements might help reduce symptoms...that's all important. In the same way parents feel more comfortable with a Pandas doc because they "get it", if you think there's more than strep involved, you may benefit from seeing a doctor who deals with lyme related issues more often, or with rotating or pulsing abx. If you're with a Pandas doctor now, you can ask about the above tests and see where the results take you. But if you have that nagging feeling that you're not yet at the bottom of things, then I'd suggest adding an LLMD to the team, not simply to look for lyme but because many of them also look into other things like mold, vitamin/mineral deficiencies, inflammation markers, detox, parasites, etc. It's just been more comprehensive for us. But just like each Pandas doc has their own approach, each LLMD will vary as well. They don't walk on water, they don't know more about everything. They just approach the problem with a different perspective. You still need to find the doctor that matches your views and who can help you develop the kind of collaboration you're looking for. If you decide to pursue, you can post on the lyme forum for more ideas.