Wednesday, October 5, 2022

Antibiotic Therapy For Lyme Disease

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How The Vaccine Works

Clinical Trial of Xenodiagnosis After Antibiotic Treatment for Lyme Disease

How does the Lyme vaccine work? It targets an outer surface protein of the Lyme bacterium called OspA that is present in the ticks gut. It is estimated that a tick must feed on someone for about 36 hours before the bacteria spreads to its victim. That delay in transmission gives time for antibodies that the tick ingests from a vaccinated persons blood to attack the germs right at their source.

In small, early-stage studies, Pfizer and Valneva reported no safety problems and a good immune response from participants. The newest study will test if the vaccine, called VLA15, really protects and is safe for people. The companies aim to recruit at least 6,000 people in Lyme-prone areas including the northeast US plus Finland, Germany, the Netherlands, Poland and Sweden.

Volunteers will receive three shots, either the vaccine or a placebo, between now and next springs tick season. A year later, they will receive a single booster dose.

Were really looking at something thats a seasonal vaccine, Anderson said, so people have high antibody levels during the months when ticks are most active.

Volunteers can be as young as five and should be at high risk because they spend a lot of time in tick-infested areas, such as hikers, campers and hunters, said Dr Alan Kivitz who heads one of the study sites at the Altoona Center for Clinical Research in Duncansville, Pennsylvania.

For Memory Concentration And Focus

Improving memory is a challenge. In Lyme disease, short-term memory problems and word-retrieval problems are common. These often improve substantially with appropriate antibiotic therapy. Over time, most patients regain their cognitive function.

When memory is a problem, consider that this could be due to a primary problem with attention or with mood. An individual who can’t focus won’t be able to remember because he/she didn’t “attend” to the item in the first place. This happens to all of us when we hear someone’s name at a party if we don’t focus on the name and perhaps make a mental association to the name to enhance memory storage, we will forget that name within minutes. Patients with depression often experience problems with memory and verbal fluency when the depression is resolved, the memory and verbal fluency typically resolve as well.

  • Medications: Attention can be improved with certain medications, such as bupropion , atomoxetine , modafinil , or stimulants . Medications that temporarily slow cognitive decline in Alzheimer’s disease or memantine ) have not been studied in Lyme disease.
  • There is some evidence that online brain training programs can enhance concentration or processing speed.
  • Neurofeedback may be helpful in improving attention, as well as in improving sleep and reducing pain. This has been studied for migraines, fibromyalgia, and ADHD.

Iv Antibiotic Regimen: Cephalosporin Plus Azole Plus Liposomal Cinnamon Clove And Oregano

  • ceftriaxone 2 gm IV 2 times a day for 4 days on and 3 days off
  • tinidazole 500 mg taken orally 1 pill 2-3 times a day for 4 days on and 3 days off in 7-day cycles
  • liposomal cinnamon, clove, and oregano capsules 1 pill 2 times a day

Key Points:

  • Various antibiotics can be used as IV. I use this one most commonly because it is the easiest to administer and one of the lowest cost IV regimens. The ceftriaxone is given in a syringe and injected over 10 minutes. This is also a pulse dose regimen . Ceftriaxone could be given daily instead as 2 gm IV 1 time a day.
  • I have found various pulse dose regimens of tinidazole to work. These include 2 weeks on and 2 weeks off or in the regimen seen here.

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What To Try If You Have Failed Years Of Antibiotics

In my practice for those that have failed years of regular antibiotics I offer two persister oriented regimes. Both of these regimens have some published clinical evidence of benefit. One regimen I offer is a Horowitz dapsone persister regimen. The other option I offer is a disulfiram only regimen or a disulfiram combination regimen . You can read more details about how to take both of these regimens in

Antimicrobial Herbs That Kill Growing Phase Spirochetes & Cysts

LYME DISEASE TREATMENT: PROPHYLAXIS, EARLY LYME, ...

Intracellular and Extracellular

Based on my observations, these herbal combination options have as good of a chance as the prescription options. They appear to kill intracellular and extracellular Lyme too based on the clinical benefit I see in my medical practice.

  • Cats Claw and Otoba Bark Tinctures 30 drops of each 2 times a day. Start at 5 drops 2 times a day and add 1 drop per dose per day until you reach 30 drops 2 times a day. If you get a Herxheimer reaction, stop increasing the dose until it has passed.
  • Cats Claw and Japanese Knotweed 30 drops of Cats Claw 2 times a day and ½ tsp of Japanese Knotweed 3 times a day. Work up to these doses over 30 days. Start Cats Claw at 5 drops 2 times a day and add 1 drop per dose per day until you reach 30 drops 2 times a day. Start the Japanese Knotweed at ¼ tsp 3 times a day and in two weeks increase to ½ tsp 3 times a day.

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What To Expect At The Vets Office

If your pet has been diagnosed with uncomplicated Lyme disease, this is what you can expect to happen at your veterinarians office.

  • Depending on the type of test used to screen for Lyme disease, a confirmatory test may be necessary.
  • Urine protein screening — In general, only dogs who have symptoms of Lyme disease or protein in their urine should be treated with antibiotics.
  • Dogs with protein in their urine should have regularly scheduled rechecks to monitor their condition.

Oral Antibiotics For Early Treatment Of Lyme

The bacteria involved in spreading Lyme disease throughout the body are intelligent. They find ways to hide in the bloodstream along the lining, making it hard for antibiotics to find and attack. The bacteria are also robust. They can move and replicate even when traveling against the flow of blood.

Plus, to eliminate Lyme bacteria, Borrelia burgdorferi, the bacterias antibodies must be present at the time of antibiotic treatment. This means that if your doctor prescribes antibiotics for two weeks, the bacteria are in hibernation during those two weeks, and they can remain after the treatment ends.

Timing is everything when using oral antibiotics. This becomes even more true for patients who have had Lyme disease for a long time. Oral antibiotics are not as successful when treating late or chronic Lyme disease, plus they can have side effects.

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What Is The Treatment For Lyme Disease

The first-line standard of care treatment for adults with Lyme disease is doxycycline, a tetracycline antibiotic. Other antibiotics that have activity against borrelia include the penicillin-like antibiotic, amoxicillin, and the second generation cephalosporin, Ceftin. The mainstay of treatment is with oral antibiotics, but intravenous antibiotics are sometimes indicated for more difficult to treat cases of neurologic-Lyme disease, such as meningitis, and cases of late Lyme arthritis.

Lyme Disease Antibiotic Combination Examples

Lyme Disease: The Latest Guidelines on Testing, Prophylaxis, and Treatment

In my experience, I find the prescription antibiotic combinations below work 85 to 90 percent of the time. The herbal combination options help 85 to 90 percent of the time. I find all these combinations more successful than the Andrographis/Japanese knotweed/cats claw combinations that some like herbalist Stephen Harrod Buhner and Bill Rawls, MD, recommend. The Buhner/Rawls combination helps about 60 to 65 percent of the time in my clinical observations. To reach the success rates I describe here, it is essential to follow the first ten steps of The Ross Lyme Support Protocol to support the immune system.

Key Points: Each combination

  • Combines antibiotics to treat all forms of the germ.
  • Combines antibiotics to treat Lyme living outside and inside of cells.
  • Combines antibiotics that work in different ways to attack the germ from different angles.
  • Treats all growth phases of Lyme at the same time – this means treatments include antimicrobials that address persisters in addition to the growth phase of the term.

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Us Europe Begin Testing 1st Possible Lyme Disease Vaccine In 20 Years

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Researchers are seeking thousands of volunteers in the U.S. and Europe to test the first potential vaccine against Lyme disease in 20 years in hopes of better fighting the tick-borne threat.

Lyme is a growing problem, with cases rising and warming weather helping ticks expand their habitat. While a vaccine for dogs has long been available, the only Lyme vaccine for humans was pulled off the U.S. market in 2002 from lack of demand, leaving people to rely on bug spray and tick checks.

Now Pfizer and French biotech Valneva are aiming to avoid previous pitfalls in developing a new vaccine to protect both adults and kids as young as 5 from the most common Lyme strains on two continents.

Read more: Tick season is here but experts say no reason for Canadians to be overly concerned

There wasnt such a recognition, I think, of the severity of Lyme disease and how many people it affects the last time around, Pfizer vaccine chief Annaliesa Anderson told The Associated Press.

Robert Terwilliger, an avid hunter and hiker, was first in line Friday when the study opened in central Pennsylvania. Hes seen lots of friends get Lyme and is tired of wondering if his next tick bite will make him sick.

Its always a worry, you know? Especially when youre sitting in a tree stand hunting and you feel something crawling on you, said Terwilliger, 60, of Williamsburg, Pennsylvania. Youve got to be very, very cautious.

Questions To Ask Your Veterinarian

If your dog has a positive Lyme test but no symptoms of the disease or protein in the urine, ask your veterinarian why he or she is recommending treatment. Experts currently recommend against antibiotic therapy under these circumstances because the dogs immune system is holding the bacteria in check and antibiotics are unable to eliminate the infection.

Dogs who have contracted Lyme disease do not develop prolonged, protective immunity and can be reinfected at a later date. Talk to your veterinarian about how best to prevent future infections. Options include measures to prevent the ticks that carry Lyme disease from biting your dog and Lyme vaccination.

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Possible Complications To Watch For With Lyme Disease

Talk to your veterinarian if you have any questions or concerns about your dogs condition.

  • Some dogs who take antibiotics can develop loss of appetite, vomiting and diarrhea.
  • Once infected, a dog will always have the bacteria that cause Lyme disease in his or her body. Therefore, relapses are possible, and owners should be on the lookout for unexplained fever, swollen lymph nodes, and/or lameness.
  • A small percentage of dogs develop kidney failure as a result of Lyme disease. Clinical signs include vomiting, weight loss, poor appetite, lethargy, increased thirst and urination, and abnormal accumulations of fluid within the body.

Only Lyme Disease Vaccine In Development Goes To Phase 3 Trial

Developing New Guidelines on Lyme Disease

Vaccine maker Pfizer says it has begun Phase 3 clinical trial of its vaccine candidate against Lyme disease with French vaccine company Valneva SE.

The biotech companies are recruiting about 6,000 participants age 5 and older at up to 50 sites in areas of Europe and the US where Lyme disease is endemic, they said Monday in a news release.

The participants will get three doses of the vaccine, called VLA15, or a placebo, followed by a booster dose.

“With increasing global rates of Lyme disease, providing a new option for people to help protect themselves from the disease is more important than ever,” Annaliesa Anderson, senior vice president and head of vaccine research and development at Pfizer, said in the news release.

VLA15 is the only Lyme vaccine in clinical development, Pfizer said in the statement. It targets the bacteria Borrelia burdorferi, the main cause of the tick-borne disease, and has “demonstrated a strong immune response and satisfactory safety profile in pre-clinical and clinical studies so far.”

If the trial shows that the vaccine is safe and effective, Pfizer says, it could submit requests for approval from the US Food and Drug Administration and the European Medicines Agency in 2025.

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Clinical Judgment And Shared Decision

  • Given the number of clinical variables that must be managed and the heterogeneity within the patient population, clinical judgment is crucial to the provision of patient-centered care.
  • Based on the GRADE model, ILADS recommends that patient goals and values regarding treatment options be identified and strongly considered during a shared decision-making process.

Treatment For Chronic Lyme Disease

Sometimes, people go through treatment for Lyme disease but their symptoms donât go away. If this lasts over 6 months, itâs known as chronic Lyme disease or âpost-treatment Lyme disease syndromeâ .

Doctors still arenât sure why some people get PTLDS. Some believe that getting Lyme disease may cause damage to your tissues or immune system. Others believe itâs because the bacteria that causes Lyme hasnât completely gone away.

There is little evidence that taking more antibiotics at this stage will help. They may actually be harmful. Instead, your doctor will focus on treating the symptoms youâre still having. This will be different for everyone. Some people could benefit from a medicine that relieves fatigue, while others may need a drug that can help with headaches or very sensitive skin.

Your doctor could also have you try a treatment that helps people with chronic fatigue syndrome or fibromyalgia.

More research is needed to figure out how best to treat PTLDS. Itâs something that can be frustrating. Just remember: Many people who have this condition do start feeling like their old selves after a few months.

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Genetic Phase And Antigenic Variation

B. burgdorferi engages in genetic, phase, and antigenic variation that shares various features with other organisms . For example, gene switching is similar to what is seen with trypanosomes, mutation and recombination are typical of HIV, variable antigen expression is seen with Neisseria species, autoinduction of dormant organisms occurs in mycobacterial infection, and fibronectin binding occurs with staphylococcal and streptococcal infection.

B. burgdorferi may assume a dormant state with cyst formation . Although spirochetal persistence in the cyst form is a controversial issue, it has recently been shown that neutrophil calprotectin can induce a dormant state in the spirochete, allowing it to persist in tissue without replicating and providing the means to avoid antibiotics .

Although antibiotic resistance associated with gene mutation was previously thought to be rare in B. burgdorferi infection , recent studies have demonstrated gene mutations in the Lyme spirochete that confer in vitro resistance to various antibiotics . The clinical implication of these gene mutations is uncertain at present.

Key Points For Healthcare Providers

Alternative treatments for Lyme disease symptoms brings new hope to those suffering
  • In patients with facial palsy who are unable to close one or both eyes, eye drops or an eye patch may be needed to prevent dry eyes.
  • Neurologic symptoms do not necessarily indicate central nervous system infection in a patient with Lyme disease.
  • Two-step serologic testing for Lyme disease is the recommended diagnostic test for neurologic Lyme disease.
  • Cerebral spinal fluid analysis is not necessary to diagnose Lyme meningitis, but can help exclude other causes of illness, such as bacterial meningitis.
  • Consider Lyme radiculoneuritis in patients who report severe limb or truncal radicular pain without preceding trauma who live in or who have traveled to Lyme-endemic areas.
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    How Do Patients Respond To Treatment

    We looked at patients with chronic Lyme diseasethose who remained ill for six or more months following treatment with antibiotics for Lyme disease . The first thing we did was identify different patients as well, high responders, low responders, or non-responders. Well patients responded positively to a survey question asking if they were well or remained ill. Those who remained ill were asked whether their condition had changed as a result of treatment. Those who said they were unchanged or worse were categorized as non-responders. Patients who said that they were better or worse following treatment, were asked how much better or worse. Those who had improved substantially were deemed high responders.

    59% of patients had improved with treatment and 42% were either well or high responders. The focus of our study was on this latter group. You might wonder whether 42% response is considered good compared to other drugs. Heres what the prior head of GlaxoSmithKline said about treatment effectiveness rates of drugs in general .

    The vast majority of drugs more than 90 per cent only work in 30 or 50 per cent of the people. Drugs out there on the market work, but they dont work in everybody. Dr. Allen Roses, GlaxoSmithKline

    So you can see that a 42% rate of substantial improvement is within the range of most drugs on the market.

    Antimicrobials That Kill Growing Phase Cysts

    Intracellular and Extracellular

    Note: I work with the following agents as anti-cyst agents based on the mechanism by which these antibiotics work and some scientific experiments. For the Rifamycins, there are no laboratory experiments showing these agents work against cysts. Clinically, I see great benefit in using the Rifamycins as my anti-cyst agents – so I list them here.

    Rifamycins

    • Rifampin 300 mg 2 pills 1 time a day or 1 pill 2 times a day
    • Rifabutin 150 mg 2 pills 1 time a day

    Azoles

    • Tinidazole 500 mg 1 pill 2 or three times a day usually pulsed for four days on then three days off of each 7 days
    • Metronidazole 500 mg 1 pill 2 or three times a day usually pulsed for four days on then three days off of each 7 days.

    Herbal

    • Grapefruit seed extract 250 mg 1 pill 2 times a day. Note this is an herbal antibiotic that I find as effective as the prescription options in this list.

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