Help - newbie. just started azithromycin after clarithromycin

[newtoallofthis]

Hello,

 

Please can someone help.

 

BRIEF VERSION

In a nutshell my daughter has just started on azithromycin (200mg three times a week) having had positive treatment on clarithromycin (187.5mg twice a day for 10 days). Whenever she has a flare (always caused by an underlying ear/throat infection) the clarithromycin normally stops the OCD within hours with a gradual reduction in anxiety. However, the throat/ear infection normally returns after a few weeks/ months - hence the move to prophylactic azithromycin by the PANDAS specialist we saw on Friday. We have much less success with penicilins incl augmentin.

 

​However, after her first dose this morning her anxiety and sensory issues have flared massively - literally within less than an hour of taking it. I also saw snippets of OCD coming back - I am dreading what the day at school may bring. My question is could this by a herx? If so why didn't we see on clarithromycin (biaxin)? I thought they were practically the same drug. Thank you so much. Am feeling scared.

 

 

BACKGROUND AND DETAIL

My 5 year old daughter has just been diagnosed with PANDAS. I suspected it when she was 2.5 years old after an overnight onset of extreme OCD, anxiety, sensory issues - at which point the doctor noted a red throat and started her on abx at my insistence.

 

Fast forward 2.5 years and we've had constant ear and throat infections - the only symptom is behavioural. At its most extreme she gets very distressing OCD and anxiety - these subside almost instantly after we start antibitiocs (generally clarithromycin as the penicillins and even augmentin don't work very well).

 

After an extreme OCD meltdown 2 weeks ago the GP noted an ulcer on her tonsils (having just 'recovered' from proper tonsillitis and ear infection treated with penicillin) and put her on clarithromycin after I refused to leave surgery without it. Almost INSTANTLY (and I mean within an hour of starting the OCD went away).

 

In this time the anxiety has decreased. We saw a PANDAS specialist on Friday who confirmed PANDAS with her history (even though waiting for blood tests) and he decided to put her on azithromycin. I am very concerned about her behavior within an hour of taking her first dose (having finished biaxin yesterday). help please....

 

Thank you

[LNN]

I suppose it could be a herx, depending on whether the bacteria you're killing is known for releasing toxins when threatened (some do, some don't). Yes, clarithromycin and zith are similar but they're not exactly the same and some bacteria will be susceptible to one and not the other. So it's hard to say if what you're seeing is a herx (a good thing as long as it's manageable and starts to subside) or a case of it not being effective and the essentially untreated infection making symptoms worse.

 

You may want to call the doctor's office and ask to switch back to clarithromycin. Did he do a swab to test for antibiotic sensitivity? Did you discuss a T&A?