Update on daughter – azithromycin reaction. Now what?

[bizzylizzy]

We started mino jan 1 and have only been able to get to m w f and keep the urticaria away. BUT … on our 2nd dosage of azith (this morning – 2nd sunday), our daugher had a big urticaria reaction show up within 30 mins.

She has been tested negative for the mycoplasm thingy, negative for inflammatory markers, but has symptoms of fibro or polymyalgia. She is 13.

What have others experiences been with urticaria. What next??

thanks

Liz 

[PhilC]

Hi Liz,

Is the azithromycin in the form of capsules or tablets? Is there anything written on them? And do you know which company makes them?

Phil

"Unthinking respect for authority is the greatest enemy of truth."
- Albert Einstein

[bizzylizzy]

made by Arrow Pharamaceuticals (NZ) ltd

'each tablet containts azithromycin monohydrate equivalent to azithromycin 500mcg'.

 

and on the tablet itself it says … AT 500. White tablet.

She has reacted to erythromycin in the past and i can see that this appears to be in the same family.

What family is clindymacin (spelling) … would that be an alternative?

Liz

[JBJBJB]

Has she tested for Lyme disease?

I have a lot of problem with yeast infection when I am on Zithromax. Does she have a lot of yeast problems, too? The zithromax seems to give me more trouble for my sinus. I have a feeling my sinus has yeast problem, too….

Poor baby, the only thing I could think of is to have her drink a lot of water and stay away from sun light. My daughter is also 13. I feel for you.

Hugs,

JB

[PhilC]

Hi Liz,

Clindamycin is a lincosamide antibiotic, and is not related to erythromycin. Is your daughter allergic to any other antibiotics, such as penicillin?

Phil

"Unthinking respect for authority is the greatest enemy of truth."
- Albert Einstein

[bizzylizzy]

We live in New Zealand, and I don't believe that we have Lyme Disease here. But I will ask her Australian AP Dr during our next consult. What is the test for Lyme disease. 

Um. what was that comment about keeping her out of the sun? What did that mean?

She tests ok for pencillin when she has skin tests, but if she takes pill that has it in it, she gets itchy.  This sensitivity is related to her 'multiple sensitivity syndrome' thing that she has going on.  I think the only antiobiotic that we have managed with is trimepthriprine (sp) – used for when she gets staph infections, and a low dos of mino (3 are only doing 3 days a week.)

I really worry about her muscle tone and movement. I see it getting less and less before our very eyes. With this pain syndrome thing going on, she feels pain intensely so we are limited in how much we do. 20 mins walk a day.  Hard now for her to swim … etc. She used to be in a swimming squad and would do 40 lengths freestyle for  warm up.  eek.

She does'nt seem to have any problems on the mino – is on nystatin for thrushy stuff.  Be thank for for small mercies.

Desperately trying to keep positive.  18 months in to this now … what kind of life is it for a kid?????

Whoops. You probably didn't need me to say that.

Liz

 

[lynnie_sydney]

Liz – unless she may have acquired Lyme in the U.S. whilst travelling, then the U.S. Lab Tests wont be applicable for Aust/NZ. Diagnosis will most probably be on a clinical basis (and even with Lab tests, final diagnosis in the U.S. is a clinical one). I think I know which doc you see in Oz (Dr S in Sydney I think??). If yes, I believe he will treat for Lyme, though this may be for infection acquired overseas. Not sure how “literate” he is with treatment protocols or whether he is in the camp that Lyme-like illness exists on every continent. Lynnie   

Be well! Lynnie

Palindromic RA 30 yrs (Chronic Lyme?)
Mino 2003-2008 100mg MWF - can no longer tolerate any tetracyclines
rotating abx protocol now. From Sep 2018 MWF - a.m. Augmentin Duo 440mg + 150mg Biaxsig (roxithromycin). p.m. Cefaclor (375mg) + Klacid 125mg + LDN 3mg + Annual Clindy IV's
Diet: no gluten, dairy, sulphites, low salicylates
Supps: 600mg N-AC BID, 1000mg Vit C, P5P 40mg, zinc picolinate 60mg, Lithium orotate 20mg, Magnesium Oil, Bio-identical hormones (DHEA + Prog + Estrog)

[superperroRA]

Shoot. 500mg of azithromycin is an elephantine dose. I only take 250mg a day, 4 times a week, and I am an adult male, 6'2″, 165 lbs (ahem, used to be 180lbs of pure (sort of) muscle before RA)
Before giving up, i would try breaking the 500mg tablet into 8 parts with a pill cutter, and giving her one dose of 62.5mg

P.S. 1000 micrograms (mcg) = 1 milligrams (mg). If you really meant 500mcg, then that's just 0.5mg, so then I'm wrong and it's not such a high dose

[PhilC]

If she is allergic to erythromycin and developed urticaria after taking azithromycin, I don't think continuing to take azithromycin at any dose is a smart idea.

Liz, is your daughter taking an antihistamine? I wonder if taking an antihistamine might be helpful in cases like hers.

If she doesn't test as allergic to penicillin but itches after taking one of the pencillins, perhaps she is sensitive to one or more of the “inert” ingredients. Or maybe the itching is a response to substances released by dead and dying bacteria. How soon does the itching appear after she takes a dose of penicillin?

If your daughter really is allergic to penicillin, she may be able to take a cephalosporin antibiotic. In the past, doctors assumed that persons allergic to pencillin would also react to the cephalosporins. It now appears that that is not always the case.

Here's some recent news on the topic:

Penicillin Allergy Might Not Include Related Antibiotic
http://www.nlm.nih.gov/medlineplus/news/fullstory_95834.html

Phil

"Unthinking respect for authority is the greatest enemy of truth."
- Albert Einstein

[bizzylizzy]

This is interesting – lots to think about.  She was also allergic to the likes of amyltriptiline (I know I've spelled that wrong) which was to decrease the pain signals going to her brain, so I don' t think it would have been a reaction in this case to 'die off' of bacteria.

I will discuss with her Dr. Ever since she was a baby, we have struggled finding antiobiotics for her to take that didn't cause a reaction – even if they were in liquid form, or in tablet. There have been many we've tried. So it is unlikely that there is some common inert substance that she is reacting to.

It brings the diagnosis back to this multiple sensitivity thing going on. Something to do with the blood brain barrier.

How would you detox the brain?  THat seems kinda out of place in this question thread, but not as far as it is talking about the one kid.

Liz

[superperroRA]

I don't know how possible or advisable it would be, especially with a child, but if her life depended on it (antibiotics could some day save her life from an infection), maybe it should be done? I believe Dr. F at Riverside tries to de-sensitize some patients to antibiotics by starting with very small doses. Children often outgrow allergies, which I suspect happens because they are exposed to small quantities of the allergen as they grow up and eventually get inured to it. (In the novel “The Count of MonteCristo”, a woman poisons her hubby by imbibing the same dose of poison as her husband, except that she had trained her body with gradually increasing doses, whereas her husband had never been exposed to the poison before.) (Since RA afflicts women 6 times more often than men, and the readership of this bulletin board is similarly lopsided, I hope I'm not giving you ladies any ideas)

I've heard of people dying from an allergic reaction to antibiotics (“anaphylactic shock”), so this is a very scary thing. I would consult a specialist in allergies
http://en.wikipedia.org/wiki/Anaphylaxis

P.S. “is on nystatin for thrushy stuff” I think a nice probiotic would do the job and be less harmful (just my opinion)(I personally love kefir and drink it by the gallon. There's also sauerkraut, yogurt and probi pills)

[PamelaR]

[user=26]superperro(RA)[/user] wrote:

Shoot. 500mg of azithromycin is an elephantine dose. I only take 250mg a day, 4 times a week, and I am an adult male, 6'2″, 165 lbs (ahem, used to be 180lbs of pure (almost) muscle before RA)
Before giving up, i would try breaking the 500mg tablet into 8 parts with a pill cutter, and giving here one dose of 62.5mg

P.S. 1000 micrograms (mcg) = 1 milligrams (mg). If you really meant 500mcg, then that's just 0.5mg, so then I'm wrong and it's not such a high dose

are you a doctor, superperro?

[superperroRA]

I'm not a physician, but I have an under-utilized phd in physics.

[maz.aust]

My daughter is allergic to Penicillin, Bactrim & Sulphur group antibiotics as well as erythromycin – found that out when she was a baby (9mths old) when she went from uticaria to anaphylactic shock in less than 4 hrs, she was also allergic to some preservatives,,, ie the coating on the tablets.

I know how hard it can be & I was just lucky that she wasn't sick very often (because it was naturopathic/homeopathic/old day remedies only for her).  Just try to remember to have her tested for tetracyclines after her 2nd teeth are fully erupted (tetracyclines don't work for all infections but do work for some, if she was tested at least you would know if she could take them). 

As for now you should maybe try clindamycin (which is a lincosamide) or ceflacor (a cephalosporin abx) — My daughter is an adult now & can take clindamycin as well as tetracyclines & vancomycin IV. 

If your daughter is like mine it won't matter if she has 1/4 tablet or a whole tablet she will react.

Good luck
Maz – Aust

 

Dec07: Diagnosed PRA, (CTD; Fibromyalgia; suspected Lyme):
Mar08: Diet to heal gut/bolster immune system (no gluten, dairy, sulphites or sugar)

Jan 2018: ABX Mon/Wed/Fri (started AP 2008)
1/2 x 150mg Roxithromycin(Biasig), 1/2 x 150mg Clarithromycin (Klacid),
1/2 x Fungillin, 1 x 250mg Cephalexin (Keflex)

All off days Probiotics

[maz.aust]

deleted by me as I had doubled up the post … sorry

Dec07: Diagnosed PRA, (CTD; Fibromyalgia; suspected Lyme):
Mar08: Diet to heal gut/bolster immune system (no gluten, dairy, sulphites or sugar)

Jan 2018: ABX Mon/Wed/Fri (started AP 2008)
1/2 x 150mg Roxithromycin(Biasig), 1/2 x 150mg Clarithromycin (Klacid),
1/2 x Fungillin, 1 x 250mg Cephalexin (Keflex)

All off days Probiotics

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