abx change: wwyd?

[thenmama]

Some of you may recall a recent post about a pattern I thought I was seeing around the timing of ds's abx doses and his daily anxiety/ocd/behavioral symptom spikes. Well, odd as it sounds, it seems there may have been something to that-- we've experimented every which way and it is very clear that something about Clindamycin is actually causing him problems-- either as a side effect in its own right, or how it affects his PANDAS. So, our ped is going to change his abx-- the question is: to what?

 

We live in central VA and the strep around here is pretty resistant (or evasive) to amox/augmentin. Dd is on it, has had multiple breakthrough strep infections, and we've done the whole Clinda/Rifampin clear her and the possible carriers in the home thing. He was on Clinda b/c he'd had perianal strep even on Augmentin. But, that was a while ago, he's had the multi-abx combos and IVIG since, and has done courses of other abx, like Omnicef and Bactrim for other things, without return of the perianal rash. The ped said Azith isn't viewed as very good for much except MycoP in this region (I've heard this elsewhere, too). That would leave Omnicef. The ped is not keen on it for ear and sinus issues anymore b/c of its poor success rate. Apparently it still seems to work pretty well for strep around here. But, he's having bad days right now, either b/c we're in the sawtooth or b/c reducing the clinda, or b/c of some other unknown (our specialty is the "some other unkowns") and the only sign of anything physical I see is some possible sinus congestion-- rings are darker, may have had some sinus pressure or headache this morning.

 

Also, he's about a month out from IVIG.

 

Ugh what to do!? And this boy is not good about revealing clues...

 

Would appreciate any thoughts, info, and advice you may have.

 

Thanks!

[Hayley]

My DD isn't on omnicef for PANDAS, but that's what our ENT always gave for ear issues so I'm surprised to hear the docs are now saying it's not good for that. My kids always tolerated it well too (and it's only once a day!) so I'd give it a shot.

[thenmama]

Thanks for the reply!

 

 

re: Omnicef, I don't know if that's the consensus everywhere-- just what I'd heard. I think our peds practice has had a lot of failures with it for ears/sinus so their opinion has been changing about its effectiveness for that. It very well could be specific to our town/region. If I recall correctly, I think there's also a theory about how s. pneumo vax and other factors in ped infectious illness and standards of care are contributing to changes in infectious illness and kids' bacterial environments and thus creating a shift in the more typical antigens for these infections-- but that's something I remember hearing but not enough about to speculate on (or articulate clearly, I'm sure...)

 

 

 

Cheers:)

[Mayzoo]

What about Keflex, or Doxycycline?

[thenmama]

Thanks for the suggestions, Mayzoo!