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?

I'm literally going through this now with my child who has Scarlett fever. We have gone for tablets rather than the syrup as this make him gag and then he is sick.

I've been crushing the tablets and adding them to jam but he is adamant they have a bitter taste. It's taken me since 12 today to get one dose into him. He is now refusing any food in case it has the medication in it. We are awaiting an ARFID diagnosis and the dietitian was very clear we shouldn't lie about putting vitamins etc onto safe foods so I'm wary of putting the medication into other foods as he only has seven safe ones at the moment.

I've been told if his symptoms don't improve within 48 hours he needs to go to a&e. I'm pretty worried and hoping he will accept some more in the jam.

Hope you succeed and your child is better soon.

I’d suggest mixing with icing sugar or milkshake syrup.

Also, perhaps after you get through this, have a look at this: https://www.e-lfh.org.uk/wp-content/uploads/2021/02/Carer-leaflet.pdf

@Thisismyusername1

My DD has been seriously ill after having scarlet fever that wasn't effectively treated. We are four months down the line and still in and out of hospital.

I'm not saying this to worry you more but to say that if you're in any doubt at all whether he's getting worse, just head to hospital (although it goes without saying that this is fraught with its own difficulties for anyone who is ND).

Also, cough medicine?! So something you can pick up in the supermarket or off the shelf in Boots without even needing a prescription?

I think you're drawing a false correlation here.

I hate taking tablets but what works for me is a fizzy drink (coke) have a mouthful first then add the tablet and swallow it all together. The bubbles make the tablet float so it doesn’t touch your tongue and you barely notice your swallowing it.
worth trying with a tictac op and then asking for tablets if it does work!

Thank you. This is what my Mum has been telling me all afternoon as well. My son actually seems really well but the GP was concerned about the rash. He also has swelling to his face which is a worry. If he doesn't manage his next dose I think we will have to go to a&e. Thank you for your advice.

So sorry to hear you're going through this. It must be very frightening. DS really struggles in medical situations with the multiple checks they have to do (temp, listening to chest, pulse, feeling lymph nodes etc) and starts to melt down. I really fear how things would go down if they had to give IV fluids.
Fingers crossed that you find a way to get the meds in and that he recovers very soon.

Will try that! And thank you I have saved that leaflet.

Good idea will try this if other ideas fail

Would mixing it in something really sweet work like golden syrup or honey?

If the pharmacist will dispense capsules, it's possible to pull the capsules apart from the middle and shake the powder inside onto something more palatable, such as a spoonful of jam or honey.

Suppositories are another effective option. Are you able to discuss the options with DS to see if he is able consider them?

We have the same problem here. Suspected autism and my 15 yr old DD just won't take tablets. She'll take liquid antibiotics though. However my GP wouldn't prescribe liquid antibiotics last time (claimed not available) but the pharmacist told me they were available but that the GP didn't want to spend the money
So we usually crush the pills but this is very hard to deal with when you have the massive long ones that are film coated so have to be swallowed whole.

DS2 is autistic (and in and out of hospital a lot due to a medical condition), and the only we can get him to take liquid meds is to mix it into Nutella and spread it on toast. Something about the toast being crunchy seems to help him get it down and keep it there. Without the toast, he shallows it, but it comes back up. Might be worth trying if you don't have success with the many other good suggestions.

If you can get a prescription for tablets, I'd recommend breaking the tablets up and putting them inside a few haribo or fruit pastilles. We divide them into quarters, so 4 sweets. Before you practice with tic tacs, maybe start smaller? Sugar sprinkles worked for us. Good luck.

Chocolate milkshake (thick!) with a straw worked
for us after everything else failed. Good luck! It’s so stressful, I feel for you.

For difficulties swallowing tablets due to ASD and SPD, I found that a capsule swallowed with a fizzy drink works best. Swallow a mouthful of fizzy so they feel comfortable knowing they can swallow, then tablet in the mouth immediately followed by a few sips of fizzy. The bubbles and strong flavor hide the fact there is anything else there.

Do they still make the ‘orange bramble’ amoxicillin? We used to occasionally get a bottle it’s orange and tastes totally different to the usual yellow one

Ok so this will sound oTT to anyone who doesn’t have a child with sensory sensitivities and who is very particular about textures and tastes.

My DS3 has a very limited diet and hates taking medication. I can’t hide stuff in his food because he is like the princess and the pea - he just knows! He can only do liquid meds. He is 13 now but ever since he could understand we have developed a 3 step medicine protocol:

1. I syringe the medicine into the side of his cheek (towards the back but not in the middle of his mouth or he will gag) he holds a glass of water whilst I’m doing this and immediately drinks it after the medicine ( not too much water or he will spit it all out)
2. As soon as he drinks the water I hand him a choc biscuit (it has to be crunchy and strong like a bourbon biscuit to mask the taste)
3. As soon as he has eaten the biscuit we breathe deeply from our noses to the count of 10(flapping slowly like birds- I don’t know why but this seems to calm him long enough past the biscuit and relax his stomach enough to digest the meds).

This is the only tried and tested way that he has medicine since he was a toddler. He is going on 14 now. It looks nuts but it works for us. The key is to explain the process simply (syringe, water, biscuit, breathe) and stick to the routine down to who holds what and when.

There are no antibiotic suppositories available in the UK

What are you talking about? I was simply explaining why taking medicine too fast like a shot could potentially be bad? My personal experience of this was with cough medicine, it happened years ago. And within 30 seconds (probably less) of me taking it in that way, I had intense chest pain and threw up (for more context, I practically NEVER throw up and had been fine beforehand - other than a cough/sore throat obviously).
Immediately called 111 and the doctor I ended up speaking to had agreed that the way I took the medicine was the cause (albeit very unusual and worrying).

It's probably a rare thing to happen judging by some of the replies here but it DID happen to me, yes with a different oral liquid medicine, but who's to say it couldn't happen with a different type of liquid medicine if it's not intended to be taken that way?

Ultimately I'm just trying to offer the OP some advice purely based on my own experience including what a doctor told me. I understand people (including professionals) have different opinions though, and if OP even wanted to get the child to do this method despite my comment, then that's absolutely their perogative of course.

Could you make up a home made version of a kfc krushem & put the tablet in a wide bore straw, one big gulp & tablet gone. My recipe is ice cream, carnation milk & ice whizzed up in the blender, then add white chocolate chips. You could even buy one Krushem, then keep the plastic cup & straw to make your own at home.

Oh, I feel his pain! I got very used to taking liquid antibiotics from a young age- I also cannot swallow tablets due to sensory issues- and I've come to the conclusion that all of them are horrible in their own unique way. I usually just chase it with a mouthful of wine gums, though I appreciate that sounds like it wouldn't work for your son. Last year I was given tablets and I had to crush them and mix them into chocolate yoghurt for them to be even somewhat palatable. You've had some great advice so far!

(Worth mentioning, I absolutely agree about asking if an alternative antibiotic could be used. It all comes down to personal taste of course, but while co-amoxiclav is the worst for me, I find flucloxacillin liquid far easier to get down and tend to request that one if the doctor thinks it will work. It still tastes horrible, but a different kind of horrible which is far easier to chase away with something sweet.)

Hoping your son recovers soon!

For the future, try getting him to swallow tic tacs to get used to swallowing tablets. That’s how my asd dc practiced to take tablets and it worked.

If a tic tac is too big, go down a size to the silver balanced for cupcakes. Then you can graduate to the next level! Good luck

Silver balls ha!