Need Advice

[Joan Pandas Mom]

My son switched to 875 mg augmentin, twice a day, 7 days ago per Dr. K, pre IVIG and will be 1 year post IVIG. Dr. K likes the 875 dose because it has the highest % of the clavulanic acid to help with I think he said inflammation. He is 160 lbs. He is NOT doing well at all and was really slipping before switching. I have a few 250 mg Azithro. Should I try giving him one every other day and see if that helps or just wait it out until IVIG next month? What would you do? I posted a few days ago, I think allergies are really playing a part too. He had a throat culture this AM too. I haven't checked his titers in about 1 month.

[peglem]

My son switched to 875 mg augmentin, twice a day, 7 days ago per Dr. K, pre IVIG and will be 1 year post IVIG. Dr. K likes the 875 dose because it has the highest % of the clavulanic acid to help with I think he said inflammation. He is 160 lbs. He is NOT doing well at all and was really slipping before switching. I have a few 250 mg Azithro. Should I try giving him one every other day and see if that helps or just wait it out until IVIG next month? What would you do? I posted a few days ago, I think allergies are really playing a part too. He had a throat culture this AM too. I haven't checked his titers in about 1 month.

Zith is taken up in the tissues, so you'd want to start with a loading dose and then maintain tissue levels. I don't know how much you have there, but I'd start with 500mg/day for 3-5 days, then maybe go 500 every other day. In my opinion 250mg every other day at his size would be like spitting on a forest fire.

[thereishope]

Those allergies are such a pain! They blur everything. Allergies can really ramp things up. I'm not saying that is the problem for your son, but if a child is in an exacerbation or very early on in recovery, allergies can really worsen things. What allergy meds does he take? My non-PANDAS son takes Claritin and the end of last week his allergies were bad even with the Claritin. Interestingly, my PANDAS son take Benadryl. His allergies symptoms remained under control even when my non-PANDAS son's worsened. The allergy med can make a difference.

Edited April 21, 2010 by Vickie

[Joan Pandas Mom]

I think you are right. I only have 3 of the 250mg. azith. My pedi agreed to prescribe the 875 of the augm for 1 month until we see Dr. K. I have consulted 3 times with Dr. T. too. He is good, but too hard to get a hold of. I will try to work on pedi, but I doubt I will get anywhere with him. He thinks IVIG is , "way out there." I feel stuck.

 

My son switched to 875 mg augmentin, twice a day, 7 days ago per Dr. K, pre IVIG and will be 1 year post IVIG. Dr. K likes the 875 dose because it has the highest % of the clavulanic acid to help with I think he said inflammation. He is 160 lbs. He is NOT doing well at all and was really slipping before switching. I have a few 250 mg Azithro. Should I try giving him one every other day and see if that helps or just wait it out until IVIG next month? What would you do? I posted a few days ago, I think allergies are really playing a part too. He had a throat culture this AM too. I haven't checked his titers in about 1 month.

Zith is taken up in the tissues, so you'd want to start with a loading dose and then maintain tissue levels. I don't know how much you have there, but I'd start with 500mg/day for 3-5 days, then maybe go 500 every other day. In my opinion 250mg every other day at his size would be like spitting on a forest fire.

[Joan Pandas Mom]

He has had Zyrtec but only a few times over the past 4 days. Does it take a while to get in the system and start to work or do you usually see results right away? It didn't seem to help much with OCD/PANDAS. He hasn't had Benadryl in about 9+ years. He has had a few bad reactions to it. He gets really hyper, crazy on it. He can take Dimetapp. Do you think that might be worth a shot? I did get a couple Hepa filters going in the house.

 

Those allergies are such a pain! They blur everything. Allergies can really ramp things up. I'm not saying that is the problem for your son, but if a child is in an exacerbation or very early on in recovery, allergies can really worsen things. What allergy meds does he take? My non-PANDAS son takes Claritin and the end of last week his allergies were bad even with the Claritin. Interestingly, my PANDAS son take Benadryl. His allergies symptoms remained under control even when my non-PANDAS son's worsened. The allergy med can make a difference.

[thereishope]

I know with Claritin, you don't get the full effect until 10 days of use. Claritin really made my PANDAS son hyper. Each kid is different. Allergies are just so bad right now, even meds can't keep up with them.

 

Is Dimetapp an antihistimine?

[worriedmommy]

Our experience is that Zyrtec will provide some immediate relief, but takes about 1-2 weeks for the full effect.

 

My daughter has severe seasonal allergies, and the tree pollen in spring is the WORST. Last year it was so bad that her eyeballs swelled and she had bleeding in one of them. She was on Zyrtec most of last year, and still needed a course of steroids to get through spring allergies. (This was all pre-PANDAS...or at least before we knew about PANDAS). Anyway, this year we've switched things up a bit. She's taking 2 nasal sprays...Veramyst (a steroid) in the morning and Patanase (an antihistamine) in the evening, and no oral allergy meds. She also just started this week with Zaditor eye drops for itchy eyes (we're doing these every morning now that the trees are flowering). So far, so good.

[EAMom]

My son switched to 875 mg augmentin, twice a day, 7 days ago per Dr. K, pre IVIG and will be 1 year post IVIG. Dr. K likes the 875 dose because it has the highest % of the clavulanic acid to help with I think he said inflammation. He is 160 lbs. He is NOT doing well at all and was really slipping before switching. I have a few 250 mg Azithro. Should I try giving him one every other day and see if that helps or just wait it out until IVIG next month? What would you do? I posted a few days ago, I think allergies are really playing a part too. He had a throat culture this AM too. I haven't checked his titers in about 1 month.

 

Ugghh. I would try to work on pedi...say he is doing worse on the Augmentin (not a high dose considering your son's size). I'm assuming he was on Azith. b-4? Was he doing better on Azith? and ask for 1 mo. refill. IMO your son should be on at least 500mg/day Azith. (that's what my 58 pound dd is on!).

 

I think you should also contact dr. K and let him know your son is slipping....that you have heard of kids resonding to higher doses of Augmentin xr that you want to try that while you are waiting for IVIG. I think 2000mg 2x daily of Augmentin would be appropriate given your son's size. (Sammy got 1000mg 2x daily but he was only 100 pounds).

 

Have you recently done throat cultures on family members?

Edited April 21, 2010 by EAMom