Testing for Food Allergies -- a great article by Dr. Stukus

     Food allergies and the testing for them can be befuddling for many families (and their doctors). We very often use the expertise of an allergist in these cases. Testing for food allergies can be a challenge (yes, that is a pun). Dr. David Stukus, M.D., pediatric allergist at Nationwide Children's Hospital here in Columbus, Ohio has an excellent discussion of testing for food allergies. Here is the article.

Testing for Strep Throat in Our Office

     I have been practicing pediatrics since 1994. When I started in practice, a rapid strep test was done in the office and an culture test was done on the negative (no strep found) rapid tests to confirm whether strep was there or not. This culture took 1-2 days to get the results. A few years ago, we and most practices in Central Ohio switched to doing the over-night tests at Nationwide Children's Hospital that was completed by the next morning, so we would know for sure if the child has strep by the start of the next office day. One of the on-going issues with the Nationwide Children's test has been the expense.
     As of April 4th, 2017 we are now doing an in-office DNA probe test for strep. It takes a few extra minutes, we swab the throat in the same way (although the swabs may be a little different), and it eliminates the need to do an overnight test. We believe the insurance coverage will be good, and in fact it will be cheaper if the previous overnight test would be needed. We like that the results are available right away, where for years we have called families the next day to tell them the overnight test was positive for strep. This delayed getting back to school (and parents back to work). Now we will know a definitive "Is it strep or not?" in about 8 minutes.

New Once-Daily Amoxicillin Dosing for Strep Throat

     For many years, the standard way to treat strep throat has been to use twice-daily dosing for amoxicillin. A recent study confirmed that once-daily dosing for amoxicillin was effective in treating strep throat. For children who are not allergic to amoxicillin or penicillin, this will be more and more common to treat strep in this way.
     The once daily dosing may seem as if the dose is a little higher than before. We commonly use the 400 milligram/5 milliliter suspension and have the children 45 pounds and above take 2 1/2 teaspoons (10.5 milliliters) once a day for 10 days. Smaller children with strep throat will take a small dose.
     One nice change: if the first dose is given before 5 p.m., your child is not contagious the next morning. The higher dosing works so quickly that the usual recommendation to wait 24 hours before your child is not contagious does not apply. We recommend that the first dose of the amoxicillin be given right away once it has been prescribed. Note that the twice daily dosing would still mean that the child was not contagious until they have been on the antibiotics for 24 hours.
     So do not be surprised if your child is given once-daily amoxicillin if they are diagnosed with strep throat. We think treating this way has some real benefits.