Should Impetigo be treated w/oral antibiotics?

[sheeboo]

Hello,

 

My almost 6 year-old daughter was diagnosed with a mild case of impetigo this morning. She began manifesting tics (vocal and motor) about a year and a half ago after a dose of children's Zyrtec which she was clearly allergic to. At the time I didn't know about PANDAS. I researched (this board was VERY helpful!) and after reading requested a Strep test. Her Dr. laughed at me because there were no signs of Strep, but sure enough, she tested positive. Her tics, which had become severe, disappeared by 90% within two days of antibiotic treatment. She has been tic-free since Oct. (antibiotics started in late Aug.)

 

My husband brought her to the Dr. this morning and at the time, we weren't aware that impetigo is in fact Strep. After he called me, I looked it up and now wonder if the best course of action is to start antibiotics immediately. Her Dr. recommended Neosporin and if it hasn't gotten better by Monday to start ABX.

 

In retrospect, dd has been clearing her throat a lot, which I just attributed to pollen...but this is how her tics began the last time.

 

Any thoughts?

 

Thank you!

Brie

[sheeboo]

Update:

 

I called the ped's office and spoke to the doctor who saw dd this morning. He hadn't read her file so he was unaware of the previous strep/tics. He fully agreed after looking at her file that she needs to be on oral ABX and prescribed them for 7 days, after which we'll see if she needs longer. How will we know, though, if we should keep on the ABX for more than 7 days?

 

Interestingly enough, he realized that she was diagnosed with Impetigo EXACTLY a year ago! And then positive for Strep in Aug. I find this interesting because my Lyme Dr. believes that disease works in an annual cycle. I know that my Lyme symptoms return every year within a week of the first time I was infected! Is it possible that PANDAS/Strep work the same?

[colleenrn]

Brie-

Glad you got oral antibiotics! In a person without PANDAS, topicals are OK for impetigo, but in PANDAS children, they need orals. I think that Bactroban (mupirocin) is more effective than just neosporin.

Colleen

[sheeboo]

Colleen,

Thanks for your quick reply!

 

Do you know if I need a script for Bactroban?

 

And what do you think about the seven-day course? Enough?

 

Thanks!

[acdrobert]

Hello - My son developed Impetigo last winter. he was immediately started on a 10 day course of Bactrim which was great because it completely knocked his tics out. Really made us beleive that he had PNADAS and not just a tic disorder.

 

good luck

 

 

 

 

 

 

 

 

 

 

Hello,

 

My almost 6 year-old daughter was diagnosed with a mild case of impetigo this morning. She began manifesting tics (vocal and motor) about a year and a half ago after a dose of children's Zyrtec which she was clearly allergic to. At the time I didn't know about PANDAS. I researched (this board was VERY helpful!) and after reading requested a Strep test. Her Dr. laughed at me because there were no signs of Strep, but sure enough, she tested positive. Her tics, which had become severe, disappeared by 90% within two days of antibiotic treatment. She has been tic-free since Oct. (antibiotics started in late Aug.)

 

My husband brought her to the Dr. this morning and at the time, we weren't aware that impetigo is in fact Strep. After he called me, I looked it up and now wonder if the best course of action is to start antibiotics immediately. Her Dr. recommended Neosporin and if it hasn't gotten better by Monday to start ABX.

 

In retrospect, dd has been clearing her throat a lot, which I just attributed to pollen...but this is how her tics began the last time.

 

Any thoughts?

 

Thank you!

Brie

[colleenrn]

Yes, you need a script for Bactroban- it is a topical. I do not think 7 days is ever long enough for a child with PANDAS, but a 10 day minimum. What antibiotic is she on?

Colleen

[sheeboo]

Colleen,

 

She is on 250ml Omnicef (Cefdinir) once a day (dh is allergic to Penicillin), which is the same ABX she took last year with such great results. This is only the second time in her life that she's had ABX of any kind. The Omnicef did, however, make her really irritable for some reason. She took it for 21 days last time.

 

My stepmom had a new tube of Bactroban in the house from a recent surgery, so I will start her on that tonight. I also read that Manuka honey (made from the flowers of Tea Tree) is a strong natural antibactrial/antibiotic that works really well and actually works better than antibiotic cremes for things like MRSA. We have some in the house and I put that on too and the redness went away within five minutes! I think I'll alternate between the honey and the Bactroban.

 

I've been re-reading all my PANDAS links and I agree, 7 days probably isn't long enough. The pharmacist actually gave me 10 days worth.

 

What is your take (if any) on the "annual" nature of this?

 

Thanks too ancrobert for your input. I think Bactrim is a sulfa drug, no? I *think* I'm allergic to sulfa drugs, which might be why that wasn't prescribed?

 

When we first started down this PANDAS road, this board was more helpful than any of the doctors we saw!

 

Thanks to ALL of you for sharing your stories.

[Kayanne]

I have four children, and my son had impetigo for the first time in mid-January '08, and he broke out with it again February '09. It makes me wonder about the yearly cycle thing.

 

That was the start of all of our strep in our house this year. He was on a 10 day course of antibiotics, and then in March he was the first to show signs of a strep throat.

 

All ###### broke loose after that---several perscriptions later...I hope the step is finally out of the house!

 

Can I get Manuka honey at any health store? Every once in a while, my son gets a spot that reminds me of impetigo, and I put neosporin on it, and it seems to go away...I strongly suspect that he has strep is in his skin. Does anyone know if the Bactroban can be used all over as a preventative measure, and if this would eliminate the strep from his skin? Or maybe the Manuka honey could do that?

 

My Pediatrician believed that he could be a carrier, and simultanously put three of my kids on a 10 day course of antibiotics, and added Rifampin on days 7-10. On my son and non-Pandas daughter, it seems to have done the trick...they had negative throat cultures (for my pandas daugher, it took another 10 days of antibiotics to get her clear). But with a negative throat culture...how can I convince my Ped. to put my son on a longer course of antibiotics if I belileve it is in his skin?

 

I worry that my daughter might end up being "sensitive" to strep in her environment like many of the children I read about here.

 

~Karen

[sheeboo]

Hi Karen,

 

Thanks for your email! I'll try to respond tomorrow, but for now:

 

I don't remember where we bought our container--either at Essene in Philly or Great Pumpkin in West Chester.

I think you can buy it at any good health food store, just make sure it has a Unique Manuka Factor (UMF) of at least 10+. The UMF is the level of antibacterial properties in the honey. Google "Manuka honey" and you'll be amazed at the list of ailments it is believed to help. I have it in the house because my brother, who used to have terrible heartburn, has been using it daily for a year. It is a bit pricey, but I believe well worth it.

 

From the (small) bit of reading I've done on Bactroban and Neosporin, they can both lead to a greater immunity to antibiotics and harder to treat infections--something none of us with young people who really need antibiotics wants! The warning with the tube of Bactroban actually states this, so I'd try the honey with your daughter. I've also been crushing a clove of garlic, another "old" antibacterial (which works great for yeast, btw) and mixing it with a small bit of honey for our dd. She's been fine with this the past few days because she knows it will help kill the bugs--and keep the vampires away!

 

I have no idea if Strep remains on the skin but given how it can hide in tissue it does seem possible--any medical professionals here? It seems like a very valid concern, especially with younger PANDAS kids.

 

As a side note, another natural antibiotic I've been reading about lately is Oregano oil. It seems a lot of people with chronic Lyme use it because they can't deal with the yeast issues associated with long-term ABX use. I wonder if this would help our kiddos?

 

I really thought we were out of the woods before this happened. I can't believe how quickly the tics and ocd-ish behaviour have returned. I'm terrified but trying to stay hopeful. The antibiotics worked so well last time, but I realize now that I have to be more vigilant. This is such scary @#%^!