Strep Exposure & Remicade

Direct exposure to confirmed strep this weekend. Flippin' :ymad:!

Next Remicade infusion is scheduled for February 7th. This will be his first infusion on the 8 week schedule (last was December 13th).

My questions:

• IF he gets strep, it will likely coincide with his infusion. They won't give it to him, will they?
  
• How long can you go between infusions before building antibodies? 10 wks? 12 wks?
  
• Could he get his infusion this week instead... before possibly getting strep?
  
• Am I being stupid worrying about something that might not happen?

Thus far, he says he feels fine.

You aren't being silly!

I have seen some pretty sick kids at infusion. I would guess a fever and infection would rule out infusion.

If he is going to get the infection he will get it within 48 hours of being exposed so even if you move it up it wouldn't help. He was already exposed.

Fingers crossed he doesn't get it. O has been around flu, mono, strep...you name it and the kid hasn't gotten anything. Here's hoping he kept up with his hand washing and didn't drink out of the kids cup or kiss the kid. And since you know he was exposed you know to watch him like a hawk and haul him in for a throat culture asap so you can start treating it and he will be ready for his infusion!

WOW! Congrats he has made it almost 8 weeks!

And PS just to show you how crazy I am I would be more worried about getting the strep and having to put my kid on penicillin and walking through a hospital and getting CDiff!

^^^ Yep, can I say I'm terrified of c-diff and antibiotics since that has lead us down our current road. Hope he manages to slip by with no strep.

DS has had strep three times while on remicade and twice while on humira.
Plus at least two ear infection , cellulitis , and folliculitis .

Per our Gi for my kiddo ( yours may be different so ask if needed).
Abx for more than 24 -48 hours and no fever for 24 hours at time of infusion or injection.

Fwiw we have moved infusion dates up or out within a week of what was needed not due to infection .
They only don't like infection of unknown origin otherwise normal kid stuff has not been an issue.

Good to know, ladies. Thank you!

GI emailed back already (have I mentioned how much I like this guy?) and said that if he tests positive to treat with abx and still get the infusion. The only reason to postpone it is if he has a fever and is REALLY sick and in that case he'd likely be in the hospital anyway.

Why does there always have to be drama? I hate this. I really do. I told my husband that I just can't do anything medical anymore. It feels like there is always something and I really, really need a break.

M has been around strep many times on Remicade/Humira and so far hasn't gotten it. Hoping it will be the same for your son Mehita!

I've had strep multiple times since going on remicade.....treated it with antibiotics, no big deal.....the first case was the worst though with a fever, but it was in between infusions so no problem there.....good luck!

E had a great time at Camp Oasis, until she had to leave a day early (on Friday) with a sore throat. More about camp later...

Just took her in for a rapid strep test, and it came back positive. Of course this is all happening over the weekend. It looks like--based on this thread--that it's OK for her to start taking the penicillin that she was prescribed. I just want to make sure that there isn't some other antibiotic that might be better... She's right in between Remicade infusions, so hopefully that won't be affected.

Is C. diff the big thing to watch out for now? Any more advice on what probiotics you would recommend?

Ugh. Just ugh.

Glad she had a good time at camp!!
Too bad about the strep, but fwiw my kiddo has been on antibiotics several times since being diagnosed with Crohn's and has only gotten CDiff once. I would watch for it, but don't get too worried yet (easier said than done I know ).

We used VSL#3 around the time M had CDiff, which was prescribed by her GI.

Thanks, Maya--that's reassuring. E was on antibiotics a few months ago, when she had her abdominal infection, and she didn't get Cdiff then, so I will try to stay positive for now.

Just heard from my husband at the pharmacy, and the pharmacist changed the prescription to azithromycin. He said something about it being better when MTX is also being taken.

We have had that issue too when M was on MTX just last fall. MTX interacts with a lot of things.

In terms of CDiff, I'm sure you have heard the symptoms on here - bad diarrhea, can be watery or bloody, foul-smelling.

Good luck!! Fingers and toes crossed for you.

We were told and followed any store brand probiotic during abx prescription, we followed take antibiotics 1-2 hours later take probiotic, followed by a week of VSL #3 once antibiotics were done.
Sorry she had to go home early, heard lots of fun things went on, Friday night was just the "semi-formal" dinner so dress up in nicer clothes and Saturday is just clean up and pick up so hopefully she didn't miss too much. Jack seems to have come home with a rash all over his torso, gave him some benedryl today and hope it's nothing big

Thanks. Hope that Jack's rash goes away quickly!

They switched Ds from augmentin to a z pack for his first ear infection in April due to Mtx .
Apparently they didn't need to per Rheumo ( z pack didn't work on Ds ear infection )
Long story short he ended up on augmentin. So second ear infection a few weeks ago we had to again convince pharmacy that it was "ok"
Rheumo said the level of Mtx Ds was on would not be an issue for him to take that type of abx.
Just be sure to let the Gi know ASAP
Some infections you have to hold biologics or immunosuppressants until it clears

Yeah, the issue with some antibiotics and Mtx is that it raises the level of Mtx in your body. We got the flag when O had an ear infection once and THe GI said same as MLP's (chickie)...with the levels of Mtx used in IBD not an issue but yeah, I would let both the prescribing doc and GI know. Also, some antiobiotics leave you at more risk than others for C diff. Not that I would lose sleep over it but when the pharmacist changed the antibiotic I hope they considered that in the decision...or the fact that some affect the gut more and with IBD maybe you don't want to wake that monster.

Thanks, everyone. I e-mailed her GI last night, and hopefully I'll hear back today.

I know what you mean about the medical drama, where that panic button keeps getting pushed....it can be overwhelming....hang in there, and vent on us!!!! About the postponing the infusions if necessary, I know N had to postpone his due to c-diff after his resection and he went 12 weeks without an infusion. After that, his infusions were spaced at 10 weeks. I was so scared, but all was well in the end. Also, he was on antibiotics for about a year early on after diagnosis, and I always gave him Florastore (sacchromyces boulardi) along with it and he never had c-diff during that time. I think that his was hospital acquired, plus I guess they must have given him IV antibiotics during surgery. Hang in there, and let us know what the GI says.

Thanks, awmom.

No big news from the GI. She was OK with the azithromycin, and suggested Culterelle for a probiotic. Right now, I'm just giving E yogurt and kefir, and I'll add other probiotics once she's done taking the antibiotics. E is feeling much better--not quite at 100%, but getting there--so hopefully the azithromycin is working on the strep.

So far, so good. She's been done with the antibiotic for a few days, and all the strep symptoms have been gone since the 2nd day of antibiotics. She had some diarrhea on day 3 of antibiotics, but we started giving her Culturelle and Florastor that day, and the diarrhea hasn't come back. We'll continue those two probiotics for another month or so.

Thanks everyone, for all the advice!

Sorry I am late to this. For some reason My screen was not refreshing and showing me updated threads. Glad the strep resolved and that camp was fun.

Thanks, Kim. Is your daughter still at camp?