Augmentin & Augmentin XR

[CZL]

Hi,

Question about Augmentin and Augmentin XR:

 

Does Augmentin we talk here on the forum most mean Augmentin XR? Are there any kids taking regular Augmentin (not XR)? The difference I can only see between them is Clav acid ratio is different. XR contanins very low dose. Maybe it is NOT that simple between them!

Ok, my question is any of you take " regular" Augmentin for long term? If so, do you see continuous improvement as Augmentin XR does?

My son have been on Amoxicillin/Clav acid ( 2000mg/day -- 2000mg Amoxicillin + 285 mg clavulanate per day) for 65 days so far, we did see obvious improvement after started it for couple of days, then I started tapering other psych meds down. Now His backslide is almost to where he was. Crying in the morning for school, wakes up with irritable mood at night, mouth opening & face hitting, sometimes when he is upsetting, he hits wall with his head, not happy, moaning. His mouth biting ( he often had this in the past -- cheek/mouth biting, tongue biting) is not obvious yet -- this is good.

I am thinking maybe the Amoxicillin/Clav does not work any more? Or maybe he has drug-resistant bacteria in his body already? Although the antibiotic I am using is not exact regular Augmentin, but I guess it is similar to it. OR maybe he does need some psych meds besides antibiotic? He is still ON Paxil about 7mg, I put him back on aripiprazole 5mg two days ago. Not seeing anything yet.

 

Thanks,

Jack

[peglem]

We used regular augmentin with 10 days of rifampin- saw a nice little 3 days of good improvent at the end of that. Continued regular augmentin for another week, but saw regression w/o rifampin (and developed a stubborn yeast infection). Then added zith (500mg/day) to the augmentin for another 7 days. Stopped the augmentin (and finally got rid of the yeast) and have continued on 500mg zith, every other day. So far we're maintaining a stable improvement.

[CZL]

We used regular augmentin with 10 days of rifampin- saw a nice little 3 days of good improvent at the end of that. Continued regular augmentin for another week, but saw regression w/o rifampin (and developed a stubborn yeast infection). Then added zith (500mg/day) to the augmentin for another 7 days. Stopped the augmentin (and finally got rid of the yeast) and have continued on 500mg zith, every other day. So far we're maintaining a stable improvement.

 

Before “Augmentin”, I did try him Azithromycin ( Zithromax, made by Pfizer Licensed from PLIVA) for 38 days. Really did not see anything.

[CZL]

We used regular augmentin with 10 days of rifampin- saw a nice little 3 days of good improvent at the end of that. Continued regular augmentin for another week, but saw regression w/o rifampin (and developed a stubborn yeast infection). Then added zith (500mg/day) to the augmentin for another 7 days. Stopped the augmentin (and finally got rid of the yeast) and have continued on 500mg zith, every other day. So far we're maintaining a stable improvement.

 

Before “Augmentin”, I did try him Azithromycin ( Zithromax, made by Pfizer Licensed from PLIVA) for 38 days. Really did not see anything.

After I put him on "Augmentin" for maybe 5 days, I really could tell myself at that time " it's coming, the improvement starts showing up".

[faith]

CZL,

were you giving the 2000 mgs. of augmentin on your own or is this the doctor's script? I mean, you have the augmentin, but are you upping the dose yourself? if the doctor says its okay, I would just ask him to give the next script refill as Augmentin XR, just to be safe, there must be a reason for the XR to have a lower dose of clav, probably because the XR is going to be given at a higher mg. dose and is supposed to last all day?

 

Also, when you say you had some good improvement in the beginning, was this unusual? I mean, are there times when he wasn't on the augmentin or other abx, that you would have a couple days of no head hitting or other behaviors? just wondering. because sometimes I have a good day with my son and right now he is NOT on abx, but if I had given it that morning or the night before, I might have thought it was because of the abx or whatever thing I gave that day. just wondering what others experiences are.

 

Faith

[MomWithOCDSon]

We have tried both Augmentin and Augmentin XR. My understanding is that the XR version comes in a slightly higher dosage (maxes out in 1,000 mg. tablets, whereas regular Augmentin maxes out in 875 mg. tablets) because it is "time release" and therefore doesn't all hit the stomach at once.

 

The main difference we saw with our son was that the XR was easier on his digestive tract; the non-time release seems to be tougher on his gut, and therefore tougher for him to manage, along with everything else (OCD thoughts and behaviors) he struggles with.

 

On both the regular Augmentin and the XR we saw almost miraculous relief of some of the OCD behaviors within the first 3 days, followed by a plateauing of visible improvement, and then even a regression of some of the more "common" OCD behaviors as they've always related to our son, namely contamination fears.

 

That being said, however, on both of those options, what has noticably declined and remained consistently in decline during the abx course are the full-out emotional meltdowns. He will still have one occassionally but not over every little thing (as he did pre-abx), and the meltdowns he now has tend to be much shorter-lived and less hysterical overall. So I take that as a sign that, even though some of the contamination stuff has crept back in, his overall stability and health continues to improve.

[Alex]

Hi,

Question about Augmentin and Augmentin XR:

 

Does Augmentin we talk here on the forum most mean Augmentin XR? Are there any kids taking regular Augmentin (not XR)? The difference I can only see between them is Clav acid ratio is different. XR contanins very low dose. Maybe it is NOT that simple between them!

Ok, my question is any of you take " regular" Augmentin for long term? If so, do you see continuous improvement as Augmentin XR does?

My son have been on Amoxicillin/Clav acid ( 2000mg/day -- 2000mg Amoxicillin + 285 mg clavulanate per day) for 65 days so far, we did see obvious improvement after started it for couple of days, then I started tapering other psych meds down. Now His backslide is almost to where he was. Crying in the morning for school, wakes up with irritable mood at night, mouth opening & face hitting, sometimes when he is upsetting, he hits wall with his head, not happy, moaning. His mouth biting ( he often had this in the past -- cheek/mouth biting, tongue biting) is not obvious yet -- this is good.

I am thinking maybe the Amoxicillin/Clav does not work any more? Or maybe he has drug-resistant bacteria in his body already? Although the antibiotic I am using is not exact regular Augmentin, but I guess it is similar to it. OR maybe he does need some psych meds besides antibiotic? He is still ON Paxil about 7mg, I put him back on aripiprazole 5mg two days ago. Not seeing anything yet.

 

Thanks,

Jack

 

Jack,

 

Augmentin XR has an outer portion that is immediate release Augmentin and an inner portion that is controlled release amoxicillin resulting in a sustained level of amoxicillin in the blood for a longer period of time. Regular Augmentin is all immediate release. I have wondered before if this is the reason Sammy from 'Saving Sammy' fared well on the Augmentin XR but not as well on the lower dose Augmentin. Was it really the higher dose that made the difference, or was it the more continuous presenece of amoxicillin in the blood that did the trick? The sixty four thousand dollar question seems to be do PANDAS kids have an ongoing battle with strep or not, and is it strep you can get rid of or something you have to manage? If you have to manage it then it seems to me a more continuous presenece of antibioitic in the blood would allow the immune system to back off, in turn letting the dreaded antibodies to dissapate over time.

 

Apparently there is no such thing, in the U.S. at least, of penicillin resistant GABHS. However, other bacteira which are penicillin resistant through the production of beta -lactamase can protect GABHS by disabling the penicillin. That is where the clavulinic acid comes in to play. The clavulinic acid inhibits beta-lactamase allowing the penicillin to do it's job. If I'm reading it right, you don't need Augmentin to fight the strep, but you do need it to fight the beta-latamase bacteria present in the body, allowing the amoxicillin to get the strep.

 

Here is a link to an article that talks about this stuff.

http://www.biomedcentral.com/content/pdf/1471-2334-9-202.pdf

[CZL]

CZL,

were you giving the 2000 mgs. of augmentin on your own or is this the doctor's script? I mean, you have the augmentin, but are you upping the dose yourself? if the doctor says its okay, I would just ask him to give the next script refill as Augmentin XR, just to be safe, there must be a reason for the XR to have a lower dose of clav, probably because the XR is going to be given at a higher mg. dose and is supposed to last all day?

 

Also, when you say you had some good improvement in the beginning, was this unusual? I mean, are there times when he wasn't on the augmentin or other abx, that you would have a couple days of no head hitting or other behaviors? just wondering. because sometimes I have a good day with my son and right now he is NOT on abx, but if I had given it that morning or the night before, I might have thought it was because of the abx or whatever thing I gave that day. just wondering what others experiences are.

 

Faith

 

I only have Amoxicillin/Clav which is made locally and I thought it is similar to regular Augmentin. I upped the dose on my own decision. I am not able to find doctor who knows PANDAS in Beijing and no doctor here agrees with high dose antibiotic for long term. What all doctors here give me is WARNING, WARNING WARNING about antibiotic for long term, all I can do is to read this forum, learn what you had in here, sent emails to Moms/Dads here to seek helps. I don't know what I am doing is right or not, but for me my son does look like PANDAS and his ASO is high which I need to deal with it anyway.

When I started seeing his improvement, wow, that was amazing improvement, never never seen that before, OK in the morning for school, yelling less, crying less, he was even voluntary to help us do housework, vacuum every rooms for us, reasonable way to ask if he could buy a Lego or transformer ....

my son weighs about 170 lbs ( over weight casued by long term psych meds for his TS+OCD/self injury+mood issue) pretty tall than average. I guess 2000mg/day antibiotic is not his upper limit dose yet if dose per body weight.

One thing I should mention is when I started him "Augmentin", Aripiprazole was also added by a doctor, at that time his mouth biting was real bad, we wanted to get that under control right away no matter what. I know those changes together would make things confusion. but his biting was real bad.

Was aripiprazole doing right thing at that time? --- I questioned this as he had that couple years ago, no good response. Now I am thinking maybe aripiprazole+antibiotic both were doing right thing, I don't know yet. That's why I put him back on aripiprazole lower dose couple days ago, I will see what is going to happen.

[CZL]

We have tried both Augmentin and Augmentin XR. My understanding is that the XR version comes in a slightly higher dosage (maxes out in 1,000 mg. tablets, whereas regular Augmentin maxes out in 875 mg. tablets) because it is "time release" and therefore doesn't all hit the stomach at once.

 

The main difference we saw with our son was that the XR was easier on his digestive tract; the non-time release seems to be tougher on his gut, and therefore tougher for him to manage, along with everything else (OCD thoughts and behaviors) he struggles with.

 

On both the regular Augmentin and the XR we saw almost miraculous relief of some of the OCD behaviors within the first 3 days, followed by a plateauing of visible improvement, and then even a regression of some of the more "common" OCD behaviors as they've always related to our son, namely contamination fears.

 

That being said, however, on both of those options, what has noticably declined and remained consistently in decline during the abx course are the full-out emotional meltdowns. He will still have one occassionally but not over every little thing (as he did pre-abx), and the meltdowns he now has tend to be much shorter-lived and less hysterical overall. So I take that as a sign that, even though some of the contamination stuff has crept back in, his overall stability and health continues to improve.

Thanks MomWithOCDSon

[CZL]

Jack,

 

Augmentin XR has an outer portion that is immediate release Augmentin and an inner portion that is controlled release amoxicillin resulting in a sustained level of amoxicillin in the blood for a longer period of time. Regular Augmentin is all immediate release. I have wondered before if this is the reason Sammy from 'Saving Sammy' fared well on the Augmentin XR but not as well on the lower dose Augmentin. Was it really the higher dose that made the difference, or was it the more continuous presenece of amoxicillin in the blood that did the trick? The sixty four thousand dollar question seems to be do PANDAS kids have an ongoing battle with strep or not, and is it strep you can get rid of or something you have to manage? If you have to manage it then it seems to me a more continuous presenece of antibioitic in the blood would allow the immune system to back off, in turn letting the dreaded antibodies to dissapate over time.

 

Apparently there is no such thing, in the U.S. at least, of penicillin resistant GABHS. However, other bacteira which are penicillin resistant through the production of beta -lactamase can protect GABHS by disabling the penicillin. That is where the clavulinic acid comes in to play. The clavulinic acid inhibits beta-lactamase allowing the penicillin to do it's job. If I'm reading it right, you don't need Augmentin to fight the strep, but you do need it to fight the beta-latamase bacteria present in the body, allowing the amoxicillin to get the strep.

 

Here is a link to an article that talks about this stuff.

http://www.biomedcentral.com/content/pdf/1471-2334-9-202.pdf

Thanks Alex. I will need to read this further to have better understand.