Amoxicillin for the Treatment of Pediatric Autoimmune Disorders Associated With Streptococcal Infections

Launched by NATIONAL INSTITUTE OF MENTAL HEALTH (NIMH) · Dec 9, 2002

Keywords

ClinConnect Summary

An increasing body of evidence suggests that Group A beta-Hemolytic Streptococcal throat infections (GABHS) may trigger the onset of obsessive-compulsive disorder (OCD) and/or tic disorder in certain vulnerable children via an autoimmune process. In this subgroup of children with childhood-onset OCD and tic disorders, preliminary data suggest some children have a rapid response to amoxicillin. After only 24 to 48 hours of treatment, they have a dramatic reduction in OC symptoms and tics. To date, we have observed this phenomenon in at least 5 children, each of whom relapsed when the amoxici...

Gender

ALL

Eligibility criteria

• • Subjects with presence of OCD and/or tic disorder: Must meet lifetime diagnostic criteria (DSM III or DSM IV) for obsessive compulsive disorder or a tic disorder.
• • Pediatric onset: Symptoms of the disorder first become evident between 3 years of age and the beginning of puberty, as is generally true for rheumatic fever.
• • Episodic course of symptom severity: Clinical course is characterized by the abrupt onset of symptoms or by dramatic symptom exacerbations. Episodic course is characterized by waxing and waning or symptom severity with greater than +20 percent fluctuation from baseline.
• • Association with GABHS infection: Symptom onset or exacerbations must be temporally related to group A B-Hemolytic Streptococcal infections (GABHS), i.e., associated with positive throat culture and/or elevated anti-GABHS antibody titers.
• • Association with neurological abnormalities: During symptom exacerbations, patients will have an abnormal neurological examination, such as motoric hyperactivity and adventitious movements (i.e., choreiform movements or tics).
• • Subjects must report history of improvement in their tics and/or OCD when treated with amoxicillin.
• • No subjects who meet criteria for Autism.
• • No subjects who have neurologic disorders other than tics/TS.
• • No subjects who have and IQ less than 80.
• • No subjects who have a serious concurrent or chronic medical illness.
• • No subjects who have a history of penicillin or amoxicillin allergy.
• • No subjects with history of noncompliance with medical procedures.