GSE/Scarlet Fever/Clindamycin

[JenniferG]

Started Clindamycin on ds6 Monday. Started to finally drain sinuses. Then all of a sudden Friday complains of sore throat. And he developed a fever. Pedi did not want to do anything on Sat. Saturdayfever 101.3 and developed scarlet fever type rash....trunk and legs. Coincidently I put a couple of drops of GSE in his bottle of water. Fever broke in the middle of the night and now just has red cheeks and white around mouth. Now has sore joints...knees and ankles.

 

1. Could GSE "bring out" strep?

2. So frustrated, I started Augmentin on my own today. Bad move??? Continue or stay on Clindamycin? Appt tomorrow with Dr. Szackas

3. Why didn't the rash appear earlier in the week when I started Clindamycin? Did the GSE bring it out or is the Clindamycin not covering the strep???

 

TIA!!!!!

[ibcdbwc]

Not really sure but I doubt GSE had anything to do with anything. Incubation period for scarlet fever is 1-7days so whatever exposure may have occurred prior to the start of Clindamycin could be the cause. What dose is your son on? Perhaps the dose was not high enough to ward off a new active infection. Is anyone a strep carrier in your house?

 

The strep might just be acting as it normally does. First sore throat and fever and then 12-48 hours later a rash. Has he been cultured? He will probably require aggressive treatment, perhaps IM or IV and combination since this seems to be so recurrent. Not sure I would have discontinued the Clinda and start Augmentin. Clindamycin in proper doses should have coverage. Augmentin is actually less likely to cover treatment resistant strains long term. See study below. Those doses are for adults however.

 

"In this study in patients with acute recurrent GABHS pharyngotonsillitis, oral clindamycin 300 mg BID and oral amoxicillin/clavulanic acid 1 g BID achieved comparable rates of bacteriologic eradication at 12 days and 3 months and comparable clinical cure rates at 3 months. Patients who received clindamycin had significantly greater clinical cure rates at 12 days. Both regimens were well tolerated."

[DsMom]

Clinda is what finally broke the Strep from DS after 6 months of more constant than not Strep infections, most of that time he was on Augmentin as well, plus he had a T&A! I'd stay the course n the Clinda...

[3bmom]

You mentioned his sinuses started to drain. Maybe there was strep in the sinuses that spread to his throat and activated more of the immune system response hence the rash and arthritis symptoms.

[qannie47]

Great detective work 3bmom. Makes great sense to me.

[rowingmom]

You guys are amazing!

[3bmom]

This is a bit different but was suggested to me from my acupuncturist. Whenever my son gets a scratchy throat I give him a teaspoon of organic coconut oil. He lets it melt in his mouth, gargles and than spits it out. It is suppose to be antimicrobial. We have had a great winter so far. One cold but no exacerbations. We are however on prophylactic abx and antivirals.