# Strep throat - penicillin



## Mrs CW (Jul 12, 2004)

Help me Maz!! 

S has strep throat infection and a corresponding rash all down her trunk and back - she's had fever for last few days then the spots came up yesterday.  fever gone now, apart from exhausted and loss of appetite she's been ok in herself when not asleep.

anyway saw doc today who said her throat is v inflamed, classic signs of strep and gave us penicillin v 125mg/5ml sf soln  - 5mls 4xday.
she explained all possible side effects as S hasnt had penicillin before - main one being a rash which is pretty hard to tell obviously as she's already covered in spreading rash. 

I gave her 1st dose at 12.00 today, also some more nurofen later and shes just had calpol. She's been fine til she woke up from a sleep about an hour ago, at first she was OK, she had a couple of rice cakes and some water, then a bit of formula, and now she's been writhing around, screaming her head off as if she's in pain from something - can't tell if her throats just worse or something else - the writhing around made me think her skin's upsetting her so rubbed some oilatum cream in, seemed to soothe her for a bit, but not for long. 

how long would it take til penicillin might cause a reaction and could this be it?  
Can I give her piriton or anything to stop her itching if that's what's going on?

I just put her back to bed and she's gone quieter again.  She might of course have been tired again, but when she first woke up she was crying pretty urgently, calmed down when I got her, then got upset again - it feels like something is really irritating her - no doub the rash.

thanks hun - may just have to take her back to GP but thought you might be able to help meantime

C x


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## mazv (Jul 31, 2006)

Hi C,

Awww poor S   no wonder she's under the weather and totally out of sorts  

Classic allergic reaction to penicillin is on a scale from mild rash to anaphylaxis. So you need to be on look out for any signs of swelling around mouth/tongue or any difficulty breathing (that's the serious end of the scale). Allergy response can get worse with repeat doses (repeated exposure) so keep an eye out after each dose for the first day, would expect reaction within an hour of dose. True allergic reactions i.e. anaphylaxis are very rare though.

If it is a rash due to penicillin then you can give antihistamine e.g. Piriton to help with the itch. But really it's better to swap to another treatment if the rash is caused by the drug (iyswim) If things don't improve then contact GP again (if you haven't already)

Hugs to you both and big kiss to S to get well soon
Maz x


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## Mrs CW (Jul 12, 2004)

Thanks sweetie - phew, panic over.
I think it was something else in the end she was screaming about - still not quite sure what but she had me a bit scared there for a minute - I've never heard her scream like it, and with the writhing and rigid body it was all a bit odd.  
She had another long sleep and when she woke up I dared give her another penicillin dose, she did get a bit screamy and writhy again but a rice cake and some milk seemed to help.  I think she may have a sore front bottom with the rash heading down that way towards her legs now, lots of nappy changes and oilatum massaged in seem to be helping.

It's very hard to see any other form of rash because her back is so covered in spots now they've all merged and the whole area is just solid bright red!    Her front is starting to look similar  
She doesn't seem to be itching now, so I'm assuming she's just rather sore.  the doctor had said to come back to change antibiotics if she reacted badly but I think she is actually OK with it. She said I'd know if she wasn't herself that this was a reaction to the penicillin, and there she was really not being herself so I thought maybe this was it!  Despite all the high fevers and obviously having a sore throat I didn't even know about, she'd not reacted this badly until today, and I just thought it was too much of a coincidence having only given her the penicillin this afternoon.  But of course she's only had the rash and awful red skin since this morning so I'm sure that's what's making her not herself.  

Anyway this evening, after a bit of milk and rice cakes, and messing about she was actually smiling and doing cheeky grins again with her daddy, before losing the plot again and going back to bed! 

I've just got to work out now how on earth I'm going to give her four doses of penicillin a day, an hour before food!   

thanks for your help and hugs, it's very reassuring    

Off to bed, got both children doing tandem wake ups tonight, I'm pooped!

Claire x


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## mazv (Jul 31, 2006)

Glad to hear S perked up a bit later on  Hope today has been a bit better   Erm yeah good luck with administration    Trouble with penicllin is you can't mask it in anything as it has to be on an empty stomach   It tastes foul   Just try to get as much in as possible. Any problems then I'm sure the peads nurses on parent chat will be able to advise better than I can as I'm sure they'll have some handy tricks stored from over the years of trying to get drugs into toddlers. I just give it out and tell folk good luck  

You should hopefully turn a corner with S in the next 2 days as the antibiotics really take hold and her throat starts to clear up (rash will take a bit longer to fade completely)  

Maz x


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## Mrs CW (Jul 12, 2004)

Actually she seems to quite like the taste - ?!?  
I have one of those proper dispenser syringes (better than a nurofen one as it can't pour out the bottom!) , A&E gave it to me once for M, and she opens her mouth to have it!  She almost seems to spot it coming and get excited - what's that all about?!   

Just find it hard to get it on an empty stomach.... if she has her milk straight after will it stop it working?  
I think I managed to get 3 doses done today without too much food either side of the dose, but the last one was around bedtime and she either had to have her milk before or after...  

C x


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## mazv (Jul 31, 2006)

Hi C,

If possible try not to give her milk straight after as presence of food/milk reduces absorption so you get much less drug into the body. So hard to time though   Just try and leave as big a gap as possible if an hour isn't managable. Most impressed that S likes it though      At least you're not fighting to get it in then 

M x


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## Mrs CW (Jul 12, 2004)

Helloooooo
sorry I've got another question!
Went and got the second batch from the chemist today - didn't open it til a bit later when we got home, and saw it's a different colour.  Batch 1 is bright pinky cochinealy red, batch 2 sort of orangey red, much paler. 
Does it matter?  
Has the pharmacist perhap not put some fun colouring and maybe flavouring in this time?

C x


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## mazv (Jul 31, 2006)

Hi C,

Double check the manufacturers label on the bottle to make sure it says Penicillin on it (or might say phenoxymethyl penicillin); if it does then it is the right stuff but just probably a different brand. Different manufacturers will use different formulas and more or less artificial colourings so that's probably why the bottles look different when made up. Hope S still likes the taste of this one 

Hope she's on the mend now  

Maz x


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## Mrs CW (Jul 12, 2004)

You're right.  Peeled off all the pharmacy labels to find the bottle's original label - it's a different brand.  Oh dear, and it's orange flavoured - the first one was strawberry.  She really did actively like it !   I had no problems getting it down her, she could see me get it out of the fridge and got excited!  Crazy girl.     she likes this one, we start on it midway through tomorrow.  I've had a little taste, it's not very nice  

She's much better now thanks    The rash has gone completely, to be replaced by more eczema/heat rash  

C x


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## Mrs CW (Jul 12, 2004)

omg she loves this one too    

thanks for all your help hun  

C x


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## mazv (Jul 31, 2006)

Sorry C can't help thinking of all that lovely fruit and veg puree you made that S turned her nose up at. If only you'd known that runny bitter dayglo liquids was what she wanted     Glad to hear she's much better  

Maz x


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## Mrs CW (Jul 12, 2004)

Tell me about it


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## Mrs CW (Jul 12, 2004)

So now I have another problem  

S has just been sick several times this evening - looks like a bug  

She still has a couple of days' worth of penicillin to go, what do I do?  Keep giving it and risk it being possibly thrown up?

C x


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## mazv (Jul 31, 2006)

Hi C,

If it's not one thing it's another   Poor S   Keep giving the penicillin until it's finished, if she throws it up she throws it up   Better to at least try and finish course  

Maz x


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## Mrs CW (Jul 12, 2004)

Thanks.  I gave her the first dose of the morning and it stayed down.  And at least it was on a very empty stomach so it will have been absorbed well!!  

She seems better, hasn't been sick yet so hopefully it was an overnight thing.
I'm knackered though  

C x


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## Mrs CW (Jul 12, 2004)

Always on a weekend....... 

she had her last dose of penicillin yesterday 
So is it OK for her to have some chloramphenicol in her now infected eyes?!  

I would ask the pharmacist in our local chemist's but I got hold of the drops on the sneak (sent DH to say it was for me) when you go in asking for Optrex Infected Eyes with a small child with suspiciously red looking sticky eyes they tend to guard it with their lives all of a sudden.  
But I've had them prescribed twice now for her,  know the signs and know the dose. 

C x


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## mazv (Jul 31, 2006)

Hi C,

Typical that they are never unwell during the week (at least not usually  )

Usually first line treatment for conjunctivitis is just wiping with cooled boiled water (clean cotton wool ball for each eye every time you wipe). Simple bacterial conjunctivitis is self limiting and should clear within 5 days; if it doesn't then it's something else that needs to be seen by GP. Chloramphenicol will work too though  Again treatment should be for 5 days only and if it hasn't cleared by then then get to GP as it'll be something else causing problem. The regulations for selling chloramphenicol OTC are for children over 2 years of age only, hence why they can't sell it if they think or know it's for a small child (not really supposed to break the law when we sell medicines  ).

Hope S gets better soon   she's been in the wars recently  
Maz x


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## Mrs CW (Jul 12, 2004)

Thanks hun.  
She had a blocked duct at birth which became infected and she spent nearly all of months 2-4 with a nasty sore red eye, so bad her skin was red raw around her eye from all the constant dried gunk    but couldn't get a doctor or HV to advise anything other than boiled water, which just didn't cut it at all..... til I saw a nice locum who eventually prescribed chloramphenicol (after a bit of a battle!) and it cleared within a couple of days.    She told me any illness involving mucous will tend to come out into her eye, and it's true.  Every time she gets a cold she gets a sticky eye.  Doc told me all the signs of infection as opposed to just gunky eye, we've had 2 eye infections since and optrex has cleared it up.  I still have the original prescription label so I know the dose for a LO.  

I was just worried about adding another antibiotic into the mix!

thanks for the reassurance hun.

Claire x


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