Antibiotics For Chronic Lyme Disease

Lyme Disease Antibiotic Combination Examples

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.

The Chance Of Getting Lyme Disease

Not all ticks in England carry the bacteria that causes Lyme disease.

But it’s still important to be aware of ticks and to safely remove them as soon as possible, just in case.

Ticks that may cause Lyme disease are found all over the UK, but high-risk places include grassy and wooded areas in southern and northern England and the Scottish Highlands.

SINCLAIR STAMMERS/SCIENCE PHOTO LIBRARY https://www.sciencephoto.com/media/263611/view

Ticks are tiny spider-like creatures that live in woods, areas with long grass, and sometimes in urban parks and gardens. They’re found all over the UK.

Ticks do not jump or fly. They attach to the skin of animals or humans that brush past them.

Once a tick bites into the skin, it feeds on blood for a few days before dropping off.

New Antibiotics For Lyme Disease

Researchers in the Lyme disease community were aware that the commonly prescribed antibiotics for Lyme disease were ineffective against chronic Lyme, so they set out to identify more effective treatments. The goal was to repurpose already approved medications by screening medications from drug libraries. Testing already-approved medications with established safety profiles allow quick identification of effective treatments without developing new medications, attaining approval, and establishing safety in humans.

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Risk Factors For Post

Youre at a greater risk for post-treatment Lyme disease syndrome if youre infected by the bite of a diseased tick. If the infection progresses to the chronic stage, your symptoms might continue for weeks, months, or even years after the initial tick bite.

You may also be at a higher risk for these long-term symptoms if youre not treated with the recommended antibiotics. However, even people who receive antibiotic therapy are at risk. Because the cause of post-treatment Lyme disease syndrome is unknown, theres no way to determine whether it will progress to the chronic stage.

Typically, the symptoms of post-treatment Lyme disease syndrome resemble those that occur in earlier stages. People with persistent symptoms often experience lingering episodes of:

Why This Is Important

The use and duration of antibiotics for chronic Lyme disease treatment is controversial because there is no biomarker that can determine whether the Lyme bacteria has been eradicated in CLD patients. Patients are often told that either chronic Lyme disease does not exist or that it is incurable. If this were true, we would not expect more well and substantially improved patients to be taking antibiotics. Instead, we might have expected the percentage of people using antibiotics to be roughly the same among the patient subgroups.

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Tetracycline Plus Rifamycin Plus Disulfiram

• minocycline 100 mg 1 pill 2 times a day
• rifampin 300 mg 2 pills 1 time a day
• disulfiram 4 to 5 mg/ kg body weight. Work up to this dose slowly over 2 months then remain on the disulfiram at the peak dose for 4 months before tapering off.

Key Points:

• This minocycine and rifampin in this combination are as useful for treating a Bartonella co-infection. Co-infections are other germs passed on during a tick bite. If someone has a co-infection, when possible I choose antibiotic combinations that simultaneously treat Lyme germs and the co-infection germs.
• The disulfiram is added here to treat persister Lyme. Note disulfiram does not appear to treat Bartonella.

Pathophysiology Of Lyme Disease

B. burgdorferi is a fascinating bacterium . It has < 1500 gene sequences with at least 132 functioning genes. In contrast, Treponema pallidum, the spirochetal agent of syphilis, has only 22 functioning genes. The genetic makeup of B. burgdorferi is quite unusual. It has a linear chromosome and 21 plasmids, which are extrachromosomal strands of DNA. This is 3 times more plasmids than any other known bacteria . Plasmids are thought to give bacteria a kind of rapid response system that allows them to adapt very rapidly to changes in the environment, and the complex genetic structure of B. burgdorferi suggests that this is a highly adaptable organism .

In addition to its complex genetic makeup, B. burgdorferi engages in so-called stealth pathology to evade the human immune response . Stealth pathology involves 4 basic strategies: immunosuppression genetic, phase, and antigenic variation physical seclusion and secreted factors . These strategies are outlined below.

Stealth pathology of Borrelia burgdorferi.

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For Depression And Anxiety

Both psychotherapy and pharmacotherapy have proven benefits for improving mood. Psychotherapy has many different types such as supportive, dynamic, cognitive behavioral, dialectical behavior therapy, transference focused psychotherapy each of which offers benefit. Pharmacotherapy also has many different types. For depression the first-line options usually are SSRIs, SNRIs, Tricyclics or other agents with more unique modes of action.

A few noteworthy tips on anti-depressant agents:

• Most anti-depressant agents also help in reducing anxiety. However the opposite isn’t necessarily true. Specific anti-anxiety agents such as clonazepam or diazepam may not necessarily help fight depression.
• Most anti-depressants take three to eight weeks before an effect is seen. Therefore, it is unwise to stop an anti-depressant after only three or four weeks, as staying on it another two to three weeks may lead to a good response.
• Dosage makes a difference. Some anti-depressants work fine at low doses some medications however are effective only at higher doses. Some medications are more effective as the dose is increased. Other antidepressants may have a therapeutic range one has to achieve at least a certain dosage .

Hunting For Alternative Drug

Frustrated by the lack of treatment options for Lyme disease patients with lingering symptoms, Rajadas and his team began hunting for a better alternative in 2011. In 2016, they published a study in Drug Design, Development and Therapy that listed 20 chemical compounds, from about 4,000, that were most effective at killing the infection in mice. All 20 had been approved by the Food and Drug Administration for various uses. One, for instance, is used to treat alcohol abuse disorder.

Jayakumar Rajadas

In this most recent study, azlocillin, one of the top-20 contenders, was shown to eclipse a total of 7,450 compounds because it is more effective in killing B. burgdorferi and causes fewer side effects. Lyme disease affects more than 300,000 people annually, according to the Centers for Disease Control and Prevention. It can affect various organs, including the brain, skin, heart, joints and nervous system, and cause heart problems and arthritis if untreated. Symptoms include fever, headaches, chills, and muscle and joint pain.

Traditional antibiotics, such as doxycycline, are effective as an early course of treatment for the infection in the majority of patients, but it remains unclear why these drugs fail to treat 10% to 20% of patients, Rajadas said.

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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.

Treatment Approach To Chronic Lyme Disease

What is the approach for a patient who presents with persistent symptoms of Lyme disease ? First, the Lyme Western blot should be repeated, and coinfection testing should be performed by a laboratory that is proficient in tickborne disease analysis. At the same time, other medical problems that could cause persistent symptoms should be ruled out. Measurement of the CD57 natural killer cell level, which is an immunologic marker that can be used to monitor treatment in chronic Lyme disease, should be performed . If neurologic symptoms are severe, a single-photon emission CT SPECT brain scan should be obtained, to see how much inflammation is present in the brain. Neuropsychiatric evaluation may also be helpful .

On the basis of these results, coinfections should be treated first, if any are present, and then oral or parenteral antibiotics should be used to treat symptoms of persistent Lyme disease. Antibiotic therapy should be administered in a rotating and open-ended manner, in conjunction with probiotics, to minimize adverse effects . Monitoring of clinical symptoms, CD57 natural killer cell levels, and markers of inflammation should be performed in conjunction with treatment .

Precedents for prolonged antibiotic therapy.

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Touched By Lyme: Ivs Remain Financial Stumbling Block For Many Lyme Patients

Long-term intravenous antibiotic treatment for Lyme disease is very expensive and often not covered by health insurance. One Wyoming couple found it pays to shop around.

Readers of this blog may remember learning about INFUSING FOR LYMIES, a free e-book written by a Lyme patient about how to save money on IV treatment for Lyme disease. Heres an email I just received from the wife of a Lyme patient:

Just stumbled onto the guide to managing PICC and IV infusion. Wish I had stumbled last October when my husband had a PICC line inserted to hopefully help stem the symptoms of his long undiagnosed Lyme Disease. We live in a 20,000 person county in Wyoming and the local hospital oncology department put in the PICC. They referred the prescription to their usual infusion provider .

Cost per week was $3000!!!!!!! First time I got paperwork I thought they meant per month! I had several conversations with them trying to understand the high cost. They claimed their hands were tied due to contracts with my insurance provider. They furthered this by saying that the contracts were to protect me! I sure didnt feel protected when my insurance refused to pay.

After 2 months I stopped the home health nurses visits at $180 a week. I never wanted to be a nurse but life moves in mysterious ways and a bit of a nurse Ive become.

Intravenous Antibiotics For Lyme: Pros Cons And The Lived Experience

byJennifer Crystalon September 3, 2020

Has your doctor recommended you get a PICC line to treat your Lyme disease? Here are the pros and cons of IV antibiotics for Lyme.

When diagnosed right away, many cases of Lyme disease can be treated with a three-week course of oral antibiotics. Some 20% of patients, however, go on to experience continued symptomsknown as Post Treatment Lyme Disease Syndromeand require more antibiotics. Still others, like myself, suffer with Late Disseminated Lyme Disease, which isnt diagnosed until months or years after a tick bite. By that point, the Lyme bacteria, called a spirochete, has replicated and invaded many systems of the body, often crossing the blood-brain barrier.

This stage of Lyme disease is so advanced that Lyme Literate Medical Doctors often recommend intravenous antibiotics, administered through a peripherally inserted central catheter . A port is placed in your arm with a line that runs directly to your heart. The port remains in your arm for as long as your doctor recommendsin some cases months or even yearsand you self-administer antibiotics. Just the idea of having a PICC line is understandably daunting to patients. Many write to me wondering if they should pursue this route. I responded briefly to this question in one of my Dear Lyme WarriorHelp! columns. In this blog, I will share more about my own experience with a PICC line, and outline pros and cons.

My Experience

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Identifying New Drugs Against Borrelia

In 2016, researchers from Stanford University used high-throughput screening to identify compounds that were effective against Lyme disease. They started with over 4,000 compounds from various drug libraries and published their findings in the paper Identification of new drug candidates against Borrelia burgdorferi using high-throughput screening. The drugs were different in their pharmacological class, chemical structure, and mechanism of action to identify effective compounds.

One of the major challenges in the discovery of potent therapeutically effective drug molecules is the lack of availability of sensitive screening tools. Though the procedure becomes fairly simple with the availability of HTS methods and large collections of drug libraries, the development of drugs against slow-growing organisms still remains an uphill task. Though a number of drugs have been tested and approved against various spirochetes, the currently available drug therapies, such as amoxicillin and doxycycline, were unable to kill B. burgdorferi persisters in vitro.

The researchers discovered 150 compounds that inhibited over 90% growth of Borrelia. The top 20 compounds with significant growth inhibition, bacteria-killing capability, and safety history were further studied. The results were published in April 2016 in the paper Identification of new drug candidates against Borrelia burgdorferi using high-throughput screening.

Tetracycline Plus Macrolide Plus Grapefruit Seed Extract Plus Japanese Knotweed

• doxycycline 100 mg 2 pills 2 times a day
• clarithromycin 500 mg 1 pill 2 times a day
• grapefruit seed extract 250 mg 1 pill 2 times a day.
• Japanese knotweed½ tsp 3 times a day

Key Points:

• Tetracyclines and macrolides both block protein production by binding to the protein production apparatus in germs called ribosomes. But they each bind to a different part of the ribosome improving the blockade of protein production.
• Japanese knotweed is added here to treat persister Lyme. It also may treat growing Lyme and can lower inflammation cytokines.

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Is There A Vaccine For Lyme Disease

A vaccine for Lyme disease was once available in the United States, but it is no longer available. The vaccines manufacturer discontinued its production in 2002, citing low sales.

According to a 2011 analysis, there were likely a number of factors leading to the decision to suspend the vaccine. These factors included:

• Class-action lawsuits
• Low public support due to efforts by anti-vaccine groups
• Concerns that the vaccine could cause arthritis
• A difficult vaccination schedule.

The CDC also notes that the vaccine loses effectiveness over time, meaning that youre probably no longer protected against Lyme disease today if you received the vaccine when it was available.

In July 2017, the FDA granted Fast Track designation for another Lyme disease vaccine candidate, VLA15. The FDA designation is intended to facilitate development and expedite review of drugs that treat serious conditions in order to get them to patients faster.

Additional reporting by George Vernadakis.

What Are The Clinical Manifestations Of Ld

Clinical manifestations are divided into early, localized disease, and later disease.

Early, localized disease: Erythema migrans a rash at the site of a recent tick bite is the most common presentation in children and adults . EM typically develops seven to 14 days after a tick bite. EM is usually > 5 cm and mainly flat. There may be central clearing or some bluish discoloration but a classic bulls eye is uncommon. EM is usually asymptomatic but is not painful to the touch, like a cellulitis. EM can be confused with a localized hypersensitivity reaction from a tick or insect bite, which is usually swollen, smaller in size and pruritic). There can be either a single erythema migrans rash or multiple rashes without extracutaneous manifestations. However, fever, malaise, headache, mild neck stiffness, myalgia and arthralgia often accompany EM.

Without treatment, EM resolves spontaneously over a four-week period, on average.

Later disease: Approximately 20% of children with LD first present to a health care provider with extracutaneous signs or symptoms that are compatible with LD. These cases may also have a recent past history of EM lesions and non-specific low-grade fever, myalgia, and fatigue upon questioning further.

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Why Antibiotics Have Limited Use For Chronic Lyme

Borrelia clears the blood quickly and uses its corkscrew shape to penetrate deeply into tissues where it is protected from antibiotics and the immune system. It can penetrate into cells, give up the corkscrew shape, and live inside of cells, thus gaining protection from the immune system and antibiotics. If confronted with a full antibiotic assault, it rolls up into dormant cyst and rides out the storm until the antibiotics are gone.

Antibiotics work best on highly threatening microbes that grow very rapidly and congregate densely in localized areas in the body . Borrelia grows very slowly in the body and only occurs in very low concentrations in tissues.

Borrelia is a master at blending in with the trillions of other microbes that make up the human microbiome . Overwhelming the host is not its mission it simply needs to scavenge enough resources to survive. Borrelias stealthy ability to lay low makes diagnosis and treatment a real challenge.

Borrelia never occurs alone. There are many stealthy microbes mycoplasma, chlamydia, Bartonella, Epstein-Barr virus , cytomegalovirus , and others that can occupy space in the microbiome. Sometimes they occur as coinfections with the tick bite, but they can already be present in the microbiome, without causing symptoms, when infection with Borrelia occurs.