Antibiotics and worsening tics

[Crunchfly]

We are brand new to this. My son started 2 motor tics a couple weeks ago immediately after a month of strep (first antibiotic did not clear it, second did). He now has a negative culture, but elevated ASO and ADB titers.

 

After only 24 hours on Augmentin, the tics seemed much less frequent, but after 48 hours they had increased dramatically in frequency.

 

Is there still hope that the Augmentin will work? Do I just need to stick it out longer?

I know I'm being impatient, but I am having a really hard time accepting that this may be our new reality.

[pr40]

usually, you see a herxing reaction before you see improvement. usually, too, augmentin is combined with zytromax and perhaps other abx. usually, months if not years of abx. once ds does not flare, you can take him of abx.

but, at times, it is not that simple and abx alone do not aliviate all pandas symptoms.

[Dedee]

My oldest son is one of the "fortunate" (if you can call it that) PANS kids that is only triggered by strep. He always responded very well to antibiotics once we got them started. If you are dealing with strictly strep you should get a good response with the Augmentin as long as the dose is high enough. If you don't see any improvement after about a week you might consider giving your doctor a call back. If this has been a long term issue it may take longer than that. It's not unusual to need to change antibiotics but Augmentin is a good one to start with. Many get good results with it. I know you are anxious to see results but I do think a few days is a little early to panic. Try giving Motrin around the clock to help with inflammation and see if that helps symptoms. Keep us updated.

 

Dedee

[rowingmom]

Ticcing has always been DD11's herx reaction with change of protocol or increased dosage. I associate it with toxin burden. Her ticcing usually dies down after a few days and with plenty of detoxing. A couple of times ticcing has disappeared completely and I have gotten my hopes up, but it is now back at a pretty low level. I've almost resigned myself that she will always deal with this. The other PANS/lyme/bartonella symptoms are almost non-existant. There, now I've done it...

 

The 48 hour time frame does seem like a herx to me. Especially if the ticcing was worse than before you began abx.

Edited April 19, 2013 by rowingmom

[Crunchfly]

Thank you for the ideas. Herxing does sound like a possibility.

 

I understand that more aggressive treatments are preferable, but I consider my son very lucky that we were able to get antibiotics this quickly at all. We are hoping to ride this out with the pediatrician as long as it remains this simple, but we are considering an appointment with Dr. Latimer (who happens to be local) in the event that we need to take it further.

[rowingmom]

Your mainstream doctor will most likely not be amenable to long term antibiotic treatment (we are talking months here). You should make an appointment with Dr L, especially if there is a wait, and get a diagnosis from a Dr who understands PANS and is able to rx proper treatment. You are so lucky to have a specialist close by.

[Crunchfly]

Our pediatrician has prescribed 10 days of augmentin followed by 1-2 months of amoxicillin. I realize amoxicillin may not be enough, and if we are seeing improvement on Augmentin, I will definitely try to petition for a longer course.

 

I would assume an appointment with Dr. Latimer is a several month wait and quite an expense. I am hoping that the pediatrician will be willing to keep us on track until then.

[WorriedDADNMOM]

I would echo that augmentin might not be enough. Azithomycin for us since we had strep and Mycoplasma high titers.

 

I would think a good probiotic would be beneficial with any long term abx.