Masking the taste of Augmentin - with candy canes
Or, "how to convince a child with pneumonia to take her antibiotics, part 1 of ... hopefully 1."
My 3.5 y/o daughter came down with pneumonia last week. While it turns out to probably have been viral, she was prescribed Augmentin (amoxicillin + clavulanic acid), and instructed to finish it.
She. Hates. Augmentin.
With a passion unmatched by anything I've seen. As far as I can tell, this is one of the most singularly nasty-tasting medicines we try to give kids. And we didn't get it flavored. The straight stuff causes her to gag and/or vomit.
So, in the spirit of trying to educate a budding young experimentalist, we conducted a sequence of experiments, lining up three spoons-full of augmentin mixed with various substances to dilute it. I asked her to tell me which of the three had the best taste. Each spoonful contained about 0.25ml augmentin suspension to about 0.25 tsp of masking agent.
I can't guarantee that anyone else's preferences will match my daughter's, but I'm including the list because she (yes, seriously) came up with some ideas we hadn't seen before. The ratings are her preferences as elicited through the taste tests.
All "recipes" are for 9ml of Augmentin. Please feel free to be disturbed at the amount of sugar in all of these options - I am too. But it got it down and mostly stayed down.
(1) The surprising winner: Candy-Cane Flavor. To make: Throw a peppermint candy cane into your food processor or (high-performance) blender. I can't guarantee it won't dull the chopping blade - but, c'mon, if you can blend an iPhone, you can blend a candy cane. Mix at about a 5-to-1 ratio of candy cane to Augmentin.
The alternate runner-up: Peppermint oil (about 8 drops) + two or three tablespoons (!!) sugar + augmentin.
It's gloopy. It's got to be horrible for their teeth (brush well after!). But it's got so much mint flavor it masks the flavor with less overall volume than anything else we tried, which resulted in less time-to-ingest. Candy canes were all her idea.
(2) Runner-up: Blackberry jam, seedless. Take my word on the seedless: We tried with a homemade dewberry jam, but she had to chew it a bit, which resulted in more exposure time and more "bleah". Go for as much fruit as possible to get a strong flavor in there. Drawback: Requires lots of dilution (meaning: several tablespoons of jam), so it takes a while.
(3) Worked for a while but now she disapproves: Chocolate syrup. There's something in the chocolate flavor that doesn't mask the ick-sweet of the augmentin. This worked, but it got a double "bleah" on every spoonful.
(4) Worked twice: Honey + (soy) milk. We hadn't had time to go shopping and were staying in a hotel over the holidays, so this was our quick hack to try to make it better. Three "bleahs".
(5) Not as good as chocolate syrup: Molasses.
(6) Also not as good as chocolate syrup: Apple Butter. (For those not familiar, Apple Butter is like very strong applesauce - it doesn't contain butter. Think peanut butter, but pure apples.)
(7) Failed - not as good as chocolate syrup or apple butter: Salted caramel sauce. On the bright side, my wife and I did enjoy it. grin.
(8) Didn't test better than blackberry: Strawberry jam. The stronger flavor of the blackberry proved a better masking agent.
Comments with additional suggestions appreciated if we ever have to do this again -- have you found something that works even better?
(From a friend: If you're reading this in advance, at Walgreens and maybe a few other places, you can get the Flavorx flavorings added when you fill the prescription. We haven't tried them yet.)
My 3.5 y/o daughter came down with pneumonia last week. While it turns out to probably have been viral, she was prescribed Augmentin (amoxicillin + clavulanic acid), and instructed to finish it.
She. Hates. Augmentin.
With a passion unmatched by anything I've seen. As far as I can tell, this is one of the most singularly nasty-tasting medicines we try to give kids. And we didn't get it flavored. The straight stuff causes her to gag and/or vomit.
So, in the spirit of trying to educate a budding young experimentalist, we conducted a sequence of experiments, lining up three spoons-full of augmentin mixed with various substances to dilute it. I asked her to tell me which of the three had the best taste. Each spoonful contained about 0.25ml augmentin suspension to about 0.25 tsp of masking agent.
I can't guarantee that anyone else's preferences will match my daughter's, but I'm including the list because she (yes, seriously) came up with some ideas we hadn't seen before. The ratings are her preferences as elicited through the taste tests.
All "recipes" are for 9ml of Augmentin. Please feel free to be disturbed at the amount of sugar in all of these options - I am too. But it got it down and mostly stayed down.
(1) The surprising winner: Candy-Cane Flavor. To make: Throw a peppermint candy cane into your food processor or (high-performance) blender. I can't guarantee it won't dull the chopping blade - but, c'mon, if you can blend an iPhone, you can blend a candy cane. Mix at about a 5-to-1 ratio of candy cane to Augmentin.
The alternate runner-up: Peppermint oil (about 8 drops) + two or three tablespoons (!!) sugar + augmentin.
It's gloopy. It's got to be horrible for their teeth (brush well after!). But it's got so much mint flavor it masks the flavor with less overall volume than anything else we tried, which resulted in less time-to-ingest. Candy canes were all her idea.
(2) Runner-up: Blackberry jam, seedless. Take my word on the seedless: We tried with a homemade dewberry jam, but she had to chew it a bit, which resulted in more exposure time and more "bleah". Go for as much fruit as possible to get a strong flavor in there. Drawback: Requires lots of dilution (meaning: several tablespoons of jam), so it takes a while.
(3) Worked for a while but now she disapproves: Chocolate syrup. There's something in the chocolate flavor that doesn't mask the ick-sweet of the augmentin. This worked, but it got a double "bleah" on every spoonful.
(4) Worked twice: Honey + (soy) milk. We hadn't had time to go shopping and were staying in a hotel over the holidays, so this was our quick hack to try to make it better. Three "bleahs".
(5) Not as good as chocolate syrup: Molasses.
(6) Also not as good as chocolate syrup: Apple Butter. (For those not familiar, Apple Butter is like very strong applesauce - it doesn't contain butter. Think peanut butter, but pure apples.)
(7) Failed - not as good as chocolate syrup or apple butter: Salted caramel sauce. On the bright side, my wife and I did enjoy it. grin.
(8) Didn't test better than blackberry: Strawberry jam. The stronger flavor of the blackberry proved a better masking agent.
Comments with additional suggestions appreciated if we ever have to do this again -- have you found something that works even better?
(From a friend: If you're reading this in advance, at Walgreens and maybe a few other places, you can get the Flavorx flavorings added when you fill the prescription. We haven't tried them yet.)
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