Adventures of an Allergist Mommy

My 6 year son old just got over a rite of passage - strep throat and scarlet fever. Unfortunately, before we could even celebrate his recovery, I noticed a swelling on the left side of his neck. It was red and tender, and it was GROWING. The pediatrician in me worried, "Damn. Lymphadenitis (infected lymph node)". No sooner had we finished one course of antibiotics than we were onto another, and the side effects were bad enough to keep him out of school for another three days. Why did my munchkin suffer so? My answer: Drug allergy. Group A streptococcal bacteria (the cause of strep throat and scarlet fever) is remarkably sensitive to penicillin. Penicillin is the first choice treatment for strep throat, and has been proven to reduce the risk of developing rheumatic fever, a post-infectious complication which can result in chronic heart disease. Problem is, my son is allergic to antibiotics in the penicillin family. At 11 months of age (8 days into his second ever co...

Macrolide antibiotics (such as azithromycin) are popular choices when treating acute ear infections in children due to a short (5 day) course of treatment, once-daily dosing, and low incidence of gastrointestinal side effects. However, macrolide antibiotics, while generally effective against the most common pathogens in acute ear infections in children (streptococcus pneumoniae, haemophilus influenzae, and moraxella catarrhalis), are quickly losing effectiveness as resistant strains of bacteria increase. A 2007 study by the CDC demonstrated a 22.7% rate of macrolide resistance among strep. pneumoniae isolates (the most common cause of ear infections). 2004 recommendations from the American Academy of Pediatrics and the American Academy of Family Physicians advised against the use of macrolides for acute ear infections unless a patient has an immediate-type allergic reaction to penicillin. However, the rate of macrolide prescription continues to dwarf the documented rate of immediate-...