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Prophylactic dose of Augmentin for son


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I posted a few weeks ago about my 3 1/2 year old son who was very sick with strep, fevers, rashes, etc.. He has had strep several times over the past months and after this last illness we decided to start him on prophylactic antibiotics and may consider removing his tonsils and adenoids (I have two kids who need a T & A, so not sure who to do first).

 

He is on his his 19th day of Zithromax and has a few days left (treatment dose b/c he was on Omnicef and still had strep, so we switched him to a longer course of Zith). My physician has agreed to start prophylactic antibiotics, but I feel we have to start with Augmentin instead of jumping to Zithromax (my older3 kids are on daily Zithromax) b/c we are not 100% sure yet that the rashes were not an allergic reaction to the Omnicef and need to stay away from all cephalosporins until he is tested.

 

If I use Augmentin daily, my thought is that if/when he has a big flareup of PANDAS symptoms, we could do a course of Zithromax. My physician wants to to find out/figure out what doses seem to work with other PANDAS children.

 

My son will be 4 this August and weighs 38 lb.

 

TIA. I really appreciate any feedback.

 

Colleen

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Colleen --

 

You say he is currently taking Zithromax, but you think he should be on prophylactic Augmentin? I'm a little confused. If the Zith is working against the strep infection, why not keep him on a prophylactic dose of that?

 

My understanding is that Zith and Augmentin work via two entirely different mechanisms, so switching to another when one is working may not get you the results you want?

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Colleen- SO sorry your baby is going through this! Just want to throw this out there. When my girls were early on in diagnosis, I discussed antibiotics with Dr T and a pandas believing ID doc at Gtown. I, of course, was/am concerned with having the kids on long term abx. They both thought that possibly the zithromax would be easier on the gut- because it can be done every other day, or twice per week, and not daily like amox/augmentin. Just a thought....

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Colleen: I am so glad to hear they continued the Azithromycin for your son and he has pulled out of this most recent illness!!!! Our twins are turning 3 on Monday, the boy is 38 pounds and he is on 200 Azithromycin daily... we will be keeping him on that until we can figure things out for him. We are retesting CBC panels this next week and CaM Kinase in August..... at that time, if things have not improved we will be considering IVIG.

 

With that said, we have seen huge improvements since starting antibiotics with mood, rashes, rages, what appeared to be OCD at 2 1/2.... he still has some mild unfounded fears but are manageable and less intense. So, I'll be surprised if the up coming lab results are worse.

 

Hope that helps, Wendy

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The reason I was thinking of doing Augmentin is that I am not sure what antibiotic we would use if he gets strep while on prophylactic antibiotics. I am too afraid to use any cephalosporin b/c we are not 100% sure he is not allergic to it and maybe that was the cause of his rash, so that prevents us from using keflex, omnicef, cefdinir, etc... My thinking was that hopefully the Augmentin would protect him from strep, but if not, we could use a treatment course of Zithromax.

 

If we put him on Zith prophylactically and he got strep, I guess we could then treat him with Augmentin?

 

He was on Zithromax three times in the fall and so we decided to try omnicef in Jan. when he got strep again and he was on Omnicef in Jan., Feb., and April for 10 days each time. It was the last time he was on Omnicef that he got a perianal strep rash while on the Omnicef, then got really sick with a head to toe body rash that we still don't know the cause of (Kawasaki, strep, allergic reaction to Omnicef, virus??)

 

I am just so confused as to what to do.

 

Colleen

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By doing a search for old posts about Augmentin, it looks like children are on anywhere from 300mg of Augmentin, twice per day, up to 2000mg per day based on their weight.

 

I am still trying to figure out a good prophylactic dose of Augmentin for my son, at least to start. My physician is willing to decrease it or increase it based on symptoms, but we are not sure of a good prophylactic dose to begin with. He will be 4 in August and weighs 38#.

 

I also wonder if, since he is currently on a treatment dose of Zithromax, would it be better to do Zithromax every other day or every 3rd day in the beginning and see if that would be enough to protect him, with the goal of twice per week. My oldre kids are on Zithromax 250 everyday, but once they are out of school and away from the plethora of strep, I may try to decrease them to 125mg/day. They have been on 250/day for almost 20 months now and I worry about that.

 

Thanks again.

Colleen

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