Autistic teen can't take antibiotics

[BellaBaxter]

DS (15 ASD) has been prescribed antibiotics (liquid as he cannot take tablets). He absolutely cannot tolerate the taste. Years ago we sat for over an hour with an amoxicillin laced milkshake only for him to throw the whole lot up.
He can not be bribed or forced. It is literally a physiological gag reflex when he tastes it, so even if I force it in it will come straight back up. He's currently locked in the bathroom.
He has a chest infection and really needs to take this - any tips?

Nothing helpful - you have my heartfelt sympathies! I was trying to get antihistamine down DD 12 on Tuesday/wed/thurs - no DX but probably autistic - siblings are autistic. She was covered in allergic reaction hives and we couldn't get anything down 😖

Is it really like a shot of alcohol? You don't have a shot of wine or beer. The reason shots are so potent is surely that there is more alcohol in a smaller amount of fluid. Whereas taking liquid medicine like this doesn't increase the dose or the concentration.

Might it be worth asking for an alternative tablet that could be crushed and mixed with jam or something?

We had amoxicillin recently and it came in a capsule. I stuck it in a piece of banana and it went down easily.

My mum used to crush tablets into strawberry jam for me. I can swallow most tablets now but one of my medications is quite large so I do the crush and jam on a spoon trick . Otherwise it just sticks in my throat. I’m 76.

I’m sorry you had that experience but there is nothing dangerous about downing medicine in one. It doesn’t “change the effect” of the drug (although there are some drugs that need to be taken in a specific way but that will be specified).

You could try putting something strong smelling under his nose eg Vicks or a lemon to further mask the taste. Probably best to pick something that smells similar to whatever you put the medicine in eg Vicks with mint, lemon with OJ.

The same thing worked for me. I started by swallowing small bits of bread, and built up to bigger and bigger ones. Eventually I was able to squish the tablet into the bread and swallow the lot. I still can't swallow tablets any other way.

Doesn't help you right now, obviously, but worth trying in the future.

(Incidentally, one thing NOT to do, not that you probably would, is to say "If you were sick enough you'd take it ". My mum used to say that every time and it really didn't help!)

The only thing that works for us is a fruit sweet straight after - fruit pastilles or fruit-tella - my DS is 14 and we have literally tried everything

Crushed in a pestle and mortar and mixed in food.

Jam sandwich?

You can buy tablet crushers now. Liquid isn’t designed to take vile it’s just there’s a limit on what can be put in liquid meds to make them more palatable believe me as after 18 years of paeds nursing I’ve battled with many children over liquid meds. Pen v is particularly gross it leaves a mouldy taste in mouth apparently. Co amoxiclav smells ok but I think it’s quite chalky.

But if you can get tablets and crush them he may notice less than the liquid tbh. Prob a lot of liquid for his age too. It’s so hard isn’t it, I have a child with asd so I know how difficult it can be, he takes tablets as his asthma meds are tablets so he’s used to it. my 3rd son didn’t take liquid meds as a toddler, I tried every trick in the book, was so frustrated I couldn’t get him to take them. Was in USA too and the meds were bubble gum flavoured so tasted ok, but we ended up putting in sunny delight as it’s so strong. He wasn’t at all well and we really wanted to avoid a hospital admission thankfully he perked up once he started taking the meds.

Have you ever worked on a dementia care ward ?
We did exactly this with many patients who couldnt/ wouldn't take tablets
It was all documented BTW as / the covert medication policy .

Thank you 🙏

I've been out today to get all sorts of jams, syrup and sweets so I'm not sure which idea to try next!

Ah thank you!

Yes I've said to him we need to try to work at the tablets now as that would avoid a lot of the stress. But for now I think he needs to try and finish this course of medication.

Lovely to know that you managed to solve the problem - well done!

I might have to do this if we can't get anywhere with this liquid medicine

@MamaAndTheSofa Awww no I wouldn't say anything like that to him. I can see how unwell he is and I know he wants to take the medicine but his body just won't let him.
Sorry you went through that 😔

Honestly I would ask for an alternative antibiotic. I was prescribed that a few years ago and I still nearly vomit when someone mentions it. I can't eat certain foods I used to take the taste away anymore and just writing this makes me feel awful.

Not sure if it will be any help but I had a heart op when I was 7 and had to take medication for a few months after that only came in tablet form, my mum taught me to take tablets by swallowing smarties x

Does he have sufficient understanding to know he needs the medication but just isn't able to comply due to the sensory overwhelm?

I have autism and have sensory issues which can sometimes mean I find it difficult to swallow tablets with water but I can swallow them as part of a mouthful of food instead - best thing is a bitesize chocolate fudge brownie but other things work too. I chew the food up till it's just ready to swallow then shove the tablet right into the middle of the mush of food. Could he try that?

I already asked for an alternative to amoxicillin and this is what they gave me 😬
I will see how things go over the next 24 hours and then see GP

We have been trying tic tacs with no success but will keep persevering!

@Mrsttcno1 my DS hated clarithromycin and was sick so much he decided staying in hospital on cannula was preferable to trying to tolerate the liquid and being sent home 😫

Yes he has enough understanding to know why he needs to take it. I think the issue is that he has the liquid medicine and he just can't tolerate the taste.

I will try the food idea with some tic tacs or something to try to get him used to it. Thank you.

Try giving him a straw, tic tic in and take a drink facing down towards the floor. That might help as well x

Half or quarter tablets in a spoon of trifle, cold custard or anything thick & sweet that he likes is much much easier than the liquid as it's foul.

Its a good tip for people with LD or dementia & swallowing difficulties as well. Obviously check with your SaLT first though if those apply.

Just to put the message out that pharmacists can't change the formulation so there would be no point returning to a community pharmacy (I know in this case it's hospital). Pharmacists can only give what's on the prescription and can't swap meds as they only get paid for what is on the prescription.

www.medicinesforchildren.org.uk/advice-guides/giving-medicines/