Can’t live without Antibiotics

[F Lock]

My 5-year old daughter caught a cold in March, which progressed to sinusitis. She took 2 days Amoxil, 6 days Augmentin+ Roxithromycin, 2 days Ceclor. Five days later, got ear ache and took 8 days Augmentin. A week later, got fever, pink ear and coughs. Took 6 days Augmentin, then switched to Ceclor. Since then until now, whenever blowing her nose, the mucus was often yellow, thick and sticky like glue. Ceclor was stopped after 2 weeks. Then she had a chest infection and wheezing. She took 2 weeks Augmentin preceding surgery in May to put in grommets, antral proof puncture/wash on the maxillary sinuses. There were moderate polymorphs, thick fluid in ears and thick pus in sinuses. She took another 2 weeks of Augmentin post surgery.
Since stopping Augmentin, cough worsened, nasal secretions turned green and got headache. After irrigating with hypertonic saline, her yucky mucus could not be blown. CT scan showed all sinuses were opaque. One night, she got 102 degrees and severe headache. Mucus culture showed S.Pneumoniae and M.Catarrhalis. Took 10 days of Augmentin preceding adenoidectomy in July. Took another 30 days Augmentin post surgery. Still cough, wheeze & yellow mucus.
After stopping Augmentin, symptoms worsened. Mucus culture showed H.Influenzae and fungus Aspergillus. Cystic fibrosis negative, chest X-ray normal, got allergic rhinitis to dust mite.
She has been using Nasonex and Seretide for over 1 year, saline nasal spray since March, Zyrtec for 1 year until May. Whenever she is off the antibiotic, she’ll get another bacteria infection. Why and how to treat pls?

[National Jewish]

Symptoms that last this long, are often because of a chronic sinus infection.  You are correct that this may have started as a common cold and then the infection spread to her sinuses.  It is possible that she is continuing to have a chronic sinus infection.  This could be of fungal origin.  Therefore none of the antibiotics she took would be effective in getting rid of the infection.  A part of the problem here is that she was probably not treated long enough to completely cure the bacterial infection and/or adequate drainage of the involved sinuses was not achieved at the time the antibiotics were given.  It would also be important to culture the bacteria and to carefully determine antibiotic sensitivity and resistance of the organisms.
While the saline nose spray that she is using will loosen, a nasal wash helps remove mucus and germs from the nose and sinuses.  This can temporarily decrease the postnasal drip and help her sinuses to drain better.  To get the most help from a nasal steroid spray use it after doing a nasal wash.  A nasal steroid spray does not provide immediate relief of symptoms. The following treatments are often recommended at National Jewish Medical and Research Center: nasal washes, nasal steroid spray, decongestant and/or antihistamine, and an antibiotic if the symptoms are due to a bacterial infection.  Please read our Sinusitis MedFact at http://www.nationaljewish.org/medfacts/sinus.html for further information.  The sinus infection may also be the cause of her continued wheezing.  If your daughter has asthma, it is also possible that the infection has simply increased her lower airway inflammation.  If her symptoms are due to sinusitis, they will last as long as the inflammation continues.  Even after the infection is gone, it is possible for the inflammation to linger.  This inflammation can last for several weeks.  Sometimes this inflammation may linger for 3 to 6 months.  Eventually the inflammation will go away, and then the wheezing will stop.  This is called reactive airways disease (RAD) and behaves a lot like asthma.  This inflammation often clears more quickly when it is treated with an inhaled steroid medicine that is used to treat asthma.  Her doctor is the best judge of this.  If she is not seeing a pediatric ENT or allergist please consider doing so