From the Guidelines
Your child's current treatment with Augmentin and prednisolone is a good starting point, but it's essential to continue the full course of antibiotics and consider additional treatments, such as Cognitive Behavioral Therapy (CBT) and potentially SSRIs, to address the OCD symptoms effectively. The sudden onset of OCD symptoms after a strep infection suggests that your child may be experiencing PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections) 1. Given the rapid improvement with prednisolone, it's crucial to continue the steroid treatment as prescribed and monitor for any potential side effects.
Some key points to consider in your child's treatment plan:
- Continue the full course of antibiotics (typically 10-14 days) to ensure the underlying infection is properly treated 1
- Consider consulting a pediatric neurologist or psychiatrist with PANDAS experience to guide the treatment plan
- Cognitive Behavioral Therapy (CBT) specifically designed for children with OCD is recommended alongside medication 1
- If symptoms persist after completing antibiotics, your doctor might consider additional treatments, such as longer antibiotic courses, IVIG (intravenous immunoglobulin), or SSRIs like fluoxetine at pediatric doses 1
- Monitor for symptom improvement within 1-2 weeks of starting antibiotics and keep detailed records of your child's symptoms and behaviors to help healthcare providers assess treatment effectiveness
It's also important to note that the treatment plan should be individualized to your child's specific needs and circumstances, taking into account the severity of the OCD symptoms, the presence of any comorbidities, and the potential risks and benefits of each treatment option 1. By working closely with your child's healthcare providers and following a comprehensive treatment plan, you can help your child achieve significant improvement in their OCD symptoms and overall quality of life.
From the Research
Treatment Overview
The treatment for sudden onset Obsessive-Compulsive Disorder (OCD) after a streptococcal (strep) infection in a 6-year-old involves a combination of antibiotics and steroids. The current treatment includes Augmentin (amoxicillin/clavulanate) and prednisolone.
Antibiotic Treatment
- The use of Augmentin has shown no impact on symptoms, which may indicate that the infection is not the primary cause of the OCD symptoms 2.
- However, it is essential to continue the antibiotic treatment to ensure that the strep infection is fully cleared.
Steroid Treatment
- The introduction of prednisolone has shown rapid improvement in symptoms, which tapered off after about four hours 3.
- The dose of prednisolone may need to be adjusted to achieve the desired therapeutic effect.
- Studies have shown that increasing the dose of prednisolone during viral infections can reduce the risk of relapse in nephrotic syndrome 3.
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
- Ibuprofen was tried before with minimal to no impact on symptoms 2.
- The use of NSAIDs, such as ibuprofen, may not be effective in treating OCD symptoms, and their use should be reserved for cases where other treatments are not effective 4.
- Additionally, the combination of NSAIDs with prednisolone may be contraindicated due to the potential for serious adverse effects on the kidneys, platelets, and gastrointestinal tract 5.