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Dosing Azith


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My 15 yr old Son was on 150 mg Clyndomicin post T&A. He started on 500 Azith today for 3 days. His pedi wants to do 3 days on 4 days off. He is 6'1" and 158 lbs. Is this a high enough dose? Should he go off it for 4 days or stay on continously? It stays in the system for 10 days?

 

IMO, no. That is not a high enough dose. He should be on 500mg/daily (every day) at the very minimum. SFmom has a 44 pound child who has been on 500mg/day for quite a while. I have a 58 pound dd who has been on 250mg/day continuously since June 08 (she was 44 pounds when she started at this dose). If she gets much bigger, we may increase it (she had IVIG last August, so we're hoping an increase will not be needed).

 

Yes, Azith has a long 1/2 life. But giving 3 days on, 4 days off amounts to just over 200mg/day...which isn't enough for a 158 pounder.

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Melanie's son was on Clindamycin for a while. You might see what her experience was (PM if she doesn't see this post). I think Clindamycin can be given longer term (they do it for acne).

 

This is what I got from a website http://www.rxlist.com/clindamycin-drug.htm re Clindamycin:

Adults: Serious infections—150 to 300 mg every 6 hours. More severe infections—300 to 450 mg every 6 hours. Pediatric Patients: Serious infections—8 to 16 mg/kg/day (4 to 8 mg/lb/day) divided into three or four equal doses. More severe infections—16 to 20 mg/kg/day (8 to 10 mg/lb/day) divided into three or four equal doses.

 

So, if your son got 150mg (how many times a day?) that is on the very low end of the dose range (esp. considering he's bigger adult size).

 

Is there any way you could get a scrip for 500mg/day of Azith for the next 3 weeks, or increase the Clindamycin for a few weeks?

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He was on 150 mg 4 x a day of the Clyndomicin. I can get azith for about 2 weeks. It has been 2 days now on the Azith and he is slipping. I'll try Melanie too and ask about the Clindomycin and pull up that article. Thanks for that. Is Azith affective in New England?

 

 

Melanie's son was on Clindamycin for a while. You might see what her experience was (PM if she doesn't see this post). I think Clindamycin can be given longer term (they do it for acne).

 

This is what I got from a website http://www.rxlist.com/clindamycin-drug.htm re Clindamycin:

Adults: Serious infections—150 to 300 mg every 6 hours. More severe infections—300 to 450 mg every 6 hours. Pediatric Patients: Serious infections—8 to 16 mg/kg/day (4 to 8 mg/lb/day) divided into three or four equal doses. More severe infections—16 to 20 mg/kg/day (8 to 10 mg/lb/day) divided into three or four equal doses.

 

So, if your son got 150mg (how many times a day?) that is on the very low end of the dose range (esp. considering he's bigger adult size).

 

Is there any way you could get a scrip for 500mg/day of Azith for the next 3 weeks, or increase the Clindamycin for a few weeks?

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Hmmm....I live in CA. There are some resistant strains of strep in the East, I'm not sure exactly where.

 

 

Joan,

 

We used to live in Connecticut when my son first had PANDAS symptoms. He responded very positively while on Clindamycin. We switched him to prophalytic Azith and he relapsed shortly after. We did not realize the change in antibiotics could have been the cause because we were moving at the time and thought it related to other factors. However I now think it is likely that Azith was not the best to control his symptoms as he is doing well now on Augmentin. We did not restart Clindamycin because he is young, does not swallow pills, and Clindamycin is horrible tasting in a liquid... but it was very effective in controlling his PANDAS symptoms. HTH!

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Clindamycin worked really well for us too. I know one of the benefits of using it for acne is that it helps with inflammation....but I couldn't find anything about it being anti-inflammatory in the body...

 

But our daughter was on three other 5-10 day courses of antibiotics before her ped put her on 300mg of clindamycin 3X/day for 10 days. She was about 42-44 lbs at the time. They did this because the rapid strep kept being positive. The clindamycin cleared that.

 

I suspect that we were seeing some anti-inflammatory benefits of it because she was suddenly able to answer yes or no questions, the crying was minimal, she was really trying to communicate, and the far away look was gone. Two days after stopping clindamycin, she started to spiral down again, and it seemed worse or more morphed....ADD type behaviors to Autistic Type....crying fits to ragey fits...

 

About 19 days later we started prednisone and 100mg azith daily as a prophylaxis.

 

When we first filled the clindamycin prescription it was for a liquid....NASTY.

 

The pharmacy gave us 150 mg capsules to open up...we added two to chocolate pudding.

 

For our daughter, it was key to clearing her infection.

 

We had a bad strain in the house...my baby was on omnicef once...my non-PANDAS daughter and son were on antibiotics three times...my husband once...me three times (amox twice...a then finally 2 zpacks).

 

I think Clindamycin is a good choice for an antibiotic...I'm not sure about long term though because I think it is pretty strong...and with dosing every 6 hours, it can be hard to get in those probiotics.

 

~Karen

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