Common Antibiotics For 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.

Potential Treatment For Lyme Disease Kills Bacteria That May Cause Lingering Symptoms Study Finds

Screening thousands of drugs, Stanford scientists determined that in mice, azlocillin, an antibiotic approved by the Food and Drug Administration, eliminated the bacteria that causes Lyme disease.

Deer ticks are vectors of Borrelia burgdorferi, the bacteria that causes Lyme disease.Scott Bauer/USDA Agricultural Research Service

For decades, the routine treatment for Lyme disease has been standard antibiotics, which usually kill off the infection. But for up to 20% of people with the tick-borne illness, the antibiotics dont work, and lingering symptoms of muscle pain, fatigue and cognitive impairment can continue for years sometimes indefinitely.

A new Stanford Medicine study in lab dishes and mice provides evidence that the drug azlocillin completely kills off the disease-causing bacteria Borrelia burgdorferi at the onset of the illness. The study suggests it could also be effective for treating patients infected with drug-tolerant bacteria that may cause lingering symptoms.

This compound is just amazing, said Jayakumar Rajadas, PhD, assistant professor of medicine and director of the Biomaterials and Advanced Drug Delivery Laboratory at the Stanford School of Medicine. It clears the infection without a lot of side effects. We are hoping to repurpose it as an oral treatment for Lyme disease. Rajadas is the senior author of the study, which was published online March 2 in Scientific Reports. The lead author is research associate Venkata Raveendra Pothineni, PhD.

Lyme Disease Antibiotics Overview

The following are four general rules I use to develop a Lyme disease antibiotic regimen.

• Rule 1. Combine antibiotics to treat all forms of the germ.
• Rule 2. Combine antibiotics to treat Lyme living outside and inside of cells.
• Rule 3. Combine antibiotics that work in different ways to attack the germ from different angles.
• Rule 4. Treat all growth phases of Lyme at the same time – this means treatments should include antimicrobials that address persisters in addition to the growth phase of the term.

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Why Are Antibiotics The First Line Of Treatment For Lyme Disease

The use of antibiotics is critical for treating Lyme disease. Without antibiotic treatment, the Lyme disease causing bacteria can evade the host immune system, disseminate through the blood stream, and persist in the body. Antibiotics go into the bacteria preferentially and either stop the multiplication of the bacteria or disrupt the cell wall of the bacteria and kill the bacteria . By stopping the growth or killing the bacteria the human host immune response is given a leg up to eradicate the residual infection. Without antibiotics, the infection in Lyme disease can evade the host immune system and more readily persist.

Chronic Lyme Disease Or Postlyme Disease Syndrome

Following an episode of Lyme disease that is treated appropriately, some persons have a variety of subjective complaints . Some of these patients have been classified as having chronic Lyme disease or postLyme disease syndrome, which are poorly defined entities. These patients appear to be a heterogeneous group. Although European patients rarely have been reported to have residual infection with B. burgdorferi , this has yet to be substantiated either in a large series of appropriately treated European patients or in a study of North American patients. Residual subjective symptoms that last weeks or months also may persist after other medical diseases . It has also been recognized that the prevalence of fatigue and/or arthralgias in the general population is > 10% .

In areas of endemicity, coinfection with B. microti or the Ehrlichia species that causes HGE may explain persistent symptoms for a small number of these patients . Randomized controlled studies of treatment of patients who remain unwell after standard courses of antibiotic therapy for Lyme disease are in progress. To date, there are no convincing published data showing that repeated or prolonged courses of oral or iv antimicrobial therapy are effective for such patients. The consensus of the IDSA expert-panel members is that there is insufficient evidence to regard chronic Lyme disease as a separate diagnostic entity.

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Questions To Ask Your Doctor

• I found a tick embedded in my skin, but I cant get it out. What should I do?
• Ive been bitten by a tick. Do I need to be seen?
• Do I need a blood test to confirm Lyme disease?
• Which antibiotic is best for me?
• How long will I have to take the antibiotic?
• What tick or insect repellent should I use for me or my child?
• How long will the symptoms last?
• What should I do if I still dont feel well a long time after I was bitten?

Herbal And Rx Antimicrobials That Treat Persisters

This is a newer area in Lyme treatment. To help justify these various antimicrobial options, I describe the experimental basis behind my recommendations. These options are ones I am using with various degrees of success in my Seattle practice. They all have either laboratory experiments supporting their use or published human experiments.

Laboratory-Based Experiment Options

Here is a list of prescription and herbal medicine options shown in lab experiments to kill persisters that I am incorporating into my treatments of Lyme and/or Bartonella.

• Disulfiram – work slowly up to 4 to 5 mg/kg body weight 1 time a day.
• Methylene Blue 50 mg 2 times a day.
• Liposomal Oregano, Cinnamon, and Clove Oils 1 capsule 2 times a day.
• Cryptolepis 5 ml 3 times a day.
• Japanese Knotweed½ tsp 3 times a day – start at ¼ tsp 1 time a day and then increase after two weeks to ½ tsp 3 times a day.
• Cats Claw 30 drops 2 times a day.

Human-Based Experiment Options

Here is a list of prescription medications shown in human experiments to help with persister Lyme.

• Disulfiram – work slowly up to 4 to 5 mg/kg body weight 1 time a day.
• Dapsone – work up to 100 mg or 200 mg 1 time a day.

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What To Expect At Home

Home care for dogs with Lyme disease is relatively straightforward. Doxycycline is usually given by mouth twice daily for at least 30 days. Improvement in the dogs symptoms should be noted within 24-48 hours. If the dogs condition fails to improve in 72 hours or worsens at any time, call your veterinarian.

If Bitten By A Tick Should I Consider Immediate Antibiotics To Prevent Lyme Disease

ILADS recommends that prophylaxis be discussed with all who have had a blacklegged tick bite.An appropriate course of antibiotics has been shown to prevent the onset of infection.

When the decision is made to use antibiotic prophylaxis, ILADS recommends 20 days of doxycycline . The decision to treat a blacklegged tick bite with antibiotics often depends on where in the country the bite occurred, whether there was evidence that the tick had begun feeding, and the age of the person who was bitten. Based on the available evidence, and provided that it is safe to do so, ILADS recommends a 20-day course of doxycycline.

Patients should also know that although doxycycline can prevent cases of Lyme disease, ticks in some areas carry multiple pathogens, some of which, including Babesia, Powassan virus, and Bartonella, are not responsive to doxycycline. This means a person could contract a tick-borne illness despite receiving antibiotic prophylaxis for their known tick bite.

ILADS recommends against single-dose doxycycline. Some doctors prescribe a single 200 mg dose of doxycycline for a known bite. However, as discussed in detail in the guidelines, this practice is based on a flawed study that has never been replicated. Read more in the ILADS treatment guidelines.

The bottom line: If you have been bitten by a blacklegged tick, you should discuss immediate antibiotic treatment with your provider as a possible course of action.

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What Causes Lyme Disease

People get Lyme disease when they are bitten by an infected tick. Ticks live in areas with a lot of plant life, such as wooded areas or fields. They sit near the top of grassy plants and low bushes. They wait there for people or animals to brush up against them. Ticks can crawl on your clothes or body for up to several hours or more before attaching to the skin.

Ticks can attach to any part of your body. They are usually found in hard-to-see areas, including the armpits, groin, or scalp. An infected tick needs to be attached to your skin for 36 to 48 hours before it passes the bacteria on to you.

People who spend time in outdoor areas where ticks are common are at higher risk of getting tick-borne diseases.

Macrolide Plus Quinine Derivative Plus Azole Plus Methylene Blue

• azithromycin 500 mg 1 pill 1 time a day
• hydroxychloroquine 200 mg 1 pill 2 times a day
• metronidazole 500 mg 1 pill 2 or 3 times a day
• methylene blue 50 mg 2 times a day

Key Points:

• Since azithromycin is not as effective as other macrolides like clarithromycin, hydroxychloroquine is used to increase the effectiveness.
• Tinidazole could be substituted for the metronidazole because it may remove biofilms more effectively.
• Methylene Blue can treat persister Lyme.

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Should I Remove A Tick And How

Yes, remove a tick. But do not manhandle the tick by squeezing it, putting Vaseline over it, or holding a hot match to it, as this may increase the chance of transmitting disease.

The tick should be removed with fine pointed tweezers. Grasp it from the side where it meets the skin, and, using steady gentle pressure, gently pull in the opposite direction from which it embedded, until the tick is released. Expect to see the skin tent as you gently pull. Place the tick in a lidded container or zip-lock bag. Wash and disinfect the bite site, your hands, and your tweezers. Avoid handling the tick.

If you use a tick removal device like a tick scoop or tick key, follow the directions given on the package for safe and effective use.

Routine prophylaxis after a recognized tick bite is not recommended. A guideline from the Infectious Disease Society of America recommends prophylactic antibiotic therapy for adults and children older than 8 years, using a single 200-mg dose of doxycycline only if all of the following criteria are met :

• The attached tick can be reliably recognized as a nymphal or adult Ixodes scapularis

• The tick has been attached for at least 36 hours, as determined by the degree of engorgement of the tick or certainty about the time of exposure to the tick

• Prophylaxis can be started within 72 hours of the time the tick was removed

• The local rate of infection of these ticks with Borrelia burgdorferi is at least 20%

• Doxycycline treatment is not contraindicated

How Long Does A Tick Need To Be Embedded For It To Transmit Disease

The longer a tick is attached, the higher the risk of transmission. Although Lyme disease is not commonly transmitted when ticks are attached for less than 24 hours, the risk of Lyme disease posed by those bites is not zero. There may be other factors that contribute to disease transmission in short duration attachments. In addition, there are other disease-causing bacteria and viruses carried by blacklegged ticks that are known to be transmitted in less than 24 hours.

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How To Avoid Tick Bites

To reduce the chance of being bitten:

• cover your skin while walking outdoors and tuck your trousers into your socks
• use insect repellent on your clothes and skin products containing DEET are best
• stay on clear paths whenever possible
• wear light-coloured clothing so ticks are easier to see and brush off

Treatment Of Erythema Migrans Rash

People treated with appropriate antibiotics in the early stages of Lyme disease usually recover rapidly and completely. Early diagnosis and proper antibiotic treatment of Lyme disease can help prevent late Lyme disease. Treatment regimens listed in the following table are for the erythema migrans rash, the most common manifestation of early Lyme disease. These regimens may need to be adjusted depending on a persons age, medical history, underlying health conditions, pregnancy status, or allergies. Consult an infectious disease specialist regarding individual patient treatment decisions. For treating other manifestations, see www.cdc.gov/Lyme/treatment.

*When different durations of antibiotics are shown to be effective for the treatment of Lyme disease, the shorter duration is preferred to minimize adverse effects, including infectious diarrhea and antimicrobial resistance.

NOTE: For people intolerant of amoxicillin, doxycycline, and cefuroxime, the macrolide azithromycin may be used, although it is less effective. People treated with azithromycin should be closely monitored to ensure that symptoms resolve.

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Should I Call My Doctor Right Away Or Wait To See If I Develop Symptoms

ILADS recommends immediately contacting your health care provider. There are steps you can take to prevent a Lyme infection, as explained below. The onset of Lyme disease symptoms can be overlooked or mistaken for other illnesses. Once symptoms are more evident, the disease may have already entered the central nervous system, and could be hard to cure. Immediate care may prevent this from happening.

How Can You Tell If Your Dog Has Lyme Disease

Hereâs the thing, even if a dog has been infected, the dog may not show any symptoms at all.

If a dog does show symptoms, usually the symptoms show up two to five months after the tick bite.

Unlike in people where the classic symptom is a red, âbullâs eyeâ rash, dogs donât develop such a rash.

Instead, one classic canine Lyme disease symptom is the sudden onset of lameness, and quite often, thatâs the only symptom. You will notice that one or more of your dogâs joints has become swollen and painful to the touch. The dog will limp, and may walk hunched over. The lameness may last for only a few days, although in some cases it may last longer or recur for months.

Other symptoms that an infected dog may develop include:

• Lethargy and weakness
• Loss of appetite

In more serious cases, an infected dog may develop severe kidney disease leading to kidney failure. In rare cases, the heart or the nervous system may also be affected. Understandably, these problems are more difficult to treat and can be fatal.

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Herbal And Prescription Antimicrobials By Function

Be aware the doses I provide below are for adults. These same prescriptions can be used with children but have lower doses. For pediatric dosing, talk with your family physician or pediatrician. Tetracyclines can be used in children under eight, but there is a risk of tooth staining. This staining seems not to be an issue if they are used for a month or less.

What Did This Study Do

This network meta-analysis included 19 randomised controlled trials involving 2,532 people with erythema migrans due to Lyme disease. No trials were based in the UK most were from the United States or Europe.

Each trial compared two or three antibiotics. Doxycycline was the most frequently used antibiotic. A number of doses and treatment durations were represented. For example, treatment length for doxycycline ranged from 10 to 21 days. For the main analyses, doxycycline was used as the reference treatment.

Both direct and indirect data were extracted from the studies. This approach is helpful when there is a shortage of head to head research, but this, and the overall low quality of included studies means that results need to be treated with some caution.

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Can Lyme Disease Be Prevented Or Avoided

The best way to prevent Lyme disease is to avoid being bitten by ticks. When you are outdoors, follow these guidelines:

• Avoid areas that are wooded, brushy, or have tall grass.
• Walk in the center of trails.
• Use an insect repellent with at least 20% DEET. It can be put on clothing or sparingly on the skin. Dont apply it to the face or hands of children.
• Treat clothing, tents, or other gear with repellents containing 0.5% permethrin.
• Wear light-colored clothing. This makes it easier to see and remove ticks from your clothes.
• Wear a long-sleeved shirt and long pants. Tuck your pant legs into your socks or boots for added protection.

After you get home, check everything and everyone for ticks.

• Bathe or shower as soon as you can to wash off any ticks that have not attached to you.
• Check your entire body for ticks. Use a mirror for places you cant see. Check your children and your pets. Common tick locations include the back of the knees, groin area, underarms, ears, scalp, and the back of the neck.
• Check any gear you used, including coats, backpacks, or tents.

Tumble dry clothes or blankets on high heat in the dryer for 10 to 15 minutes. This should kill any ticks. If clothes are dirty, wash them in hot water and dry on high heat for 60 minutes.