Need a preventative abx suggestion

[pandakid11]

Help!

School is starting. We just found out his ASO is still high after 10 months. What abx would you suggest or has worked for you? He is allergic to penn. and cannot tolerate zithro. Is doxycycline ok? It seems to help.

 

Take care.

[Kayanne]

Help!

School is starting. We just found out his ASO is still high after 10 months. What abx would you suggest or has worked for you? He is allergic to penn. and cannot tolerate zithro. Is doxycycline ok? It seems to help.

 

Take care.

My daughter takes 150mg of Omnicef as a prophylaxis. But we were sure her strep was cleared before we dropped her down to that 1/2 dose.

 

In 2009, clindamycin stopped her recurrent strep.

[EAMom]

Help!

School is starting. We just found out his ASO is still high after 10 months. What abx would you suggest or has worked for you? He is allergic to penn. and cannot tolerate zithro. Is doxycycline ok? It seems to help.

 

Take care.

 

I don't know how good doxycylcine is for strep...but you probably would want to avoid it unless it is really your only option as it has side effects (not usually recommended for younger kids due to tooth staining, also can cause sun sensitivity in all ages).

 

I would agree with Kayanne, consider a cephalosporin (eg omnicef, of keflex), or even Clindamycin (good for clearing carriers, not sure about using it long term).

 

Does you son still have his tonsils?

 

How are his symptoms? I feel like he should be on abs, but don't treat the titers (perhaps a 2-fold rise would be concerning), treat the patient (how are his symptoms?). Per Dr. Swedo: "Don't chase titers."

 

In some individuals, strep titers just fall very slowly.

[airial95]

My daughter is also allergic to penicillin, and she has done well on cefdinir.

[AmySLP]

We use Bactrim with good results