augmentin and azithromycin

[Hayley]

We had a phone consult re: my dd yesterday with Dr. T. He was wonderfully supportive and thoughtful and overall very helpful. He does feel she has PANS and is trying to help us figure out what the trigger is so hoping to get some answers!

 

She had been on Azithromycin on and off since August 8 (5 days on, five off, five on, two off before I got the doc to raise her to 7ML from 6 and make it ongoing), but only on her 8th dose today straight and her progress has been up and down (we had a good up phase before going off the last time and she's still not as bad as she was at her worst, but is very emotional/unreasonable and her clothing issues are awful!).

 

He suggested a couple of abx options while we wait for more bloodwork, including: 1) increasing the zith to 10ML per day (5ML in the am & 5 PM); 2) switching to augmentin 2x daily (5ML each am & pm); or 3) doing an augmentin/zith combo.

 

He ultimately advised the last option given her blood tests do not show any bacteria conclusively so if it's bacterial at all, it's likely silent and/or she's a low responder to strep. He prescribed each med one time per day; dosage: 5ML of the augmentin in the AM and 7ML of the zith at night.

 

It made perfect sense to me when we spoke, but I'm now wondering...if the augmentin were to be the right drug for whatever she's got in her system, is this too low a dose since it supposedly works differently from the azith and a normal treatment dose would be 2x per day versus the 1 dose per day she's on? I sent him an email, but know how busy he is so I thought I'd ask around here in the meantime to see if anyone had done a similar dosage and seen results.

 

She is 54 lbs.

[dcmom]

Hayley-

 

Dr T is great!

 

My thoughts are this:

 

Healing from pandas, for most, is saw-toothed. This means you should look for improvement on an overall weekly basis, rather than day to day. There will be bad days, steps backwards, but if you are seeing improvements week over week- I might continue with the one abx. If and when progress stalls- is when you need to be worried.

 

The other thing is- we have found that abx do not do the whole job for my two pandas kids. When they flare up, they need more than antibiotics. So- I would consider a 5 to 7 day course of regular ibuprofen. Or, if after 2 full mos of antibiotics, there is not enough progress, consider a course of steroids.

 

Also- we have found that a qualified ERP therapist has been a key factor in healing the child (and family).

 

Hang in there!

[beeskneesmommy]

We see Dr. B. who put DS, almost 6, 45 lbs on a combo of Augmentin 3/4 tsp. 2 x D and Azith 1/2 tsp 1 x D last year. After an initial herx, our son responded extremely well and we had normalcy for several months. He has had flares, the most recent of which have been more fruequent, but he responds to other sick kids without actually getting infected. there has been lots of yucky stuff going around since the spring here in Raleigh NC. Overall, he is much better than h was. We have been battling PANDAS/PITAND for several years. He has many days that are close to 100% and is totally on track with learning, development, etc. However, we are heading toward IVig now to try to get the last bit knocked out.

 

Anyway, DS has been on this abx combo for a year now an we get chem screens every 3 months. So far so good, even after a total of 2 years, as prior to this current combo, he was on some sort of daily abx for a year as well. Hope that makes sense, in a hurry.

 

This combo of Augmentin (works well primarily for Strep) and Azith (better for Myco) has changed our lives. I would do it again in a heart beat. Just make sure that you get a good probiotic and have your kiddo take it every day, at least 2 hrs. apart from the abx.

 

Best to you, Kath