Many factors that go into antibiotic selection. For stubborn sinus infections that have been partially treated, amoxicillin alone may not be enough.

Dr. Greene’s Answer:

Augmentin and amoxicillin are the same antibiotic except that the Augmentin has something called clavulanate added in to frustrate resistant bacteria.

At the heart of the amoxicillin molecule is a ring of four atoms, called the beta-lactam ring. Some bacteria have developed the ability to produce an enzyme (beta-lactamase) that can chop open that ring and deactivate the antibiotic. When amoxicillin fails, that’s often why.

Clavulanate doesn’t do much against bacteria by itself. But it does latch onto the bacteria’s beta lactamase enzyme and prevent it from chopping up the amoxicillin, so the amoxicillin can do its job.

The reason there are often more stomach issues is that Augmentin kills more bacteria, and thus also depletes a person’s beneficial bacteria.

Particularly for kids with stomach issues, taking probiotics throughout the course of antibiotics can reduce stomach issues form the antibiotics and help replenish the gut microbiome.

There are many factors that go into antibiotic selection for a particular child. In general, in a situation with fever and face pain that has been partially treated with Zithromax, amoxicillin alone may not be enough to do the trick. I usually give Augmentin and probiotics , then switch if it’s too tough to tolerate. If switching is needed, hopefully, the Augmentin will already have given kids the edge in the bacterial battle.

In addition – I often suggest trying saline nose drops or nasal sprays (or a Neti pot), warm compresses and an EarDoc to gently breakup thick mucus in the sinuses and get things moving a bit – plus, it can feel good on the face. For

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Alan Greene MD contributor

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