Azith dose for 75 lb 5 year old?

[monarchcat]

Haven't been here in a while because I needed the mental break from constantly researching/reading about PANDAS. Nutshell background: DS (10) has had PANDAS since age 5, diagnosed at 8 and on 500mg/day azith for the past year and a half. 3 IVIGs with Dr. B last year and currently doing relatively well. DD (5) diagnosed at age 3 1/2 with PANDAS after sudden onset OCD after a strep infection (we totally knew what to look for with her). She was on 100mg/day azith for a year and came off last June. Her OCD symptoms cleared very quickly after starting abx and after a year of prophylaxis, Dr. B felt we could try taking her off. She did GREAT, but is now showing PANDAS symptoms again. A few things have been bugging me over the past few weeks, but as of tonight I'm sure we are back in OCD land. I will get in touch with Dr. B when they are in the office next week, but in the meantime I want to start her on some azith I have from when she was on it before.

 

My question is how much would you start with if you were in my shoes? She's 5, but very tall and weighs 75 lbs. I want to kick this in the ###### quickly. I had her throat swabbed and titers tested about a week ago and both ASO and Anti-DNAs B and both were negative, so it could be strep, but it could also be myco or something else.

 

I think she was on 200mg/day to start with when she was diagnosed but she obviously weighed less then as it was a year as it was almost 2 years ago.

 

I am soooo upset that we seem to be back in PANDAS land again with her, but have always known it was pretty much just a matter of time. *sigh*

 

One of the reasons I want to get going quickly is that I am realizing that since yesterday she doesn't want to eat food at home. This was not one of her symptoms before (though germ fears and contamination fears from things falling on the floor was). She didn't want breakfast at home today (very unusual) and then ate a hearty lunch when we were out. We were home by 3:30pm and she didn't eat a thing after. Drank some of my drink, but didn't really want her own. Refused dinner and all snacks. You have to know my daughter to realize that this is HIGHLY abnormal.. the girl loves to eat. No tummy ache, etc. There are several other worrisome things as well.

 

Thanks...

 

Suzanne

[philamom]

Sorry to hear things are not well again. I would say at least 250mg. Hopefully, you will get through to Dr. B's office today or tomorrow.

[LaurenK]

Does your son have any co-infections? Could that be why he is relapsing?

Edited January 2, 2012 by LaurenK

[dcmom]

I have two daughters with pandas.

 

I have been doing the following with both (one is 42 lbs, one is 80lbs).

 

Both were off all antibiotics, and were great, much of the summer. When they started school, we put both on prophylactic zith, 500mg, 2x per week.

 

When I see an increase or reappearance in pandas symptoms, within 24 to 48 hours (I wait till I am sure it is not just a bad morning, but I don't wait long.) I give them a z-pack; one dose of 500 mg, followed by 4 days of 250 mg, along with 5 days of regular advil dosing.

 

If this doesn't do the trick, and symptoms are increasing, or have increased and plateaud at an uncomfortable level, I immediately contact the doctor to consider oral steroids, Iv steroids, or further treatment.

 

I am working on finding a local, knowledgeable, therapist (who takes insurance) to help jump on any ocd increases quickly with some erp also.

 

Hope this helps.

[bws]

Dr. Schulman recommends 10 mg per kilo.

 

That would translate to about 350mg of zithromax for you dd.

Do not use Greenstone brand. It does not work. Only Teva or Sandoz.

 

Hope this helps.