Antibiotics Treatment For Lyme Disease
There is much dispute about the effectiveness of long term antibiotics. Lyme patients seem to be in the center of a war between the IDSA who says Lyme is easily treated with 3 weeks of antibiotics and other Lyme Organizations such as ILADS which say long term treatment with antibiotics is necessary. Read more about the controversy here.
We have seen cases in which doctors only prescribed two pills of Doxycyclene for an acute case of Lyme disease, and we have seen cases where Lyme doctors prescribed iv antibiotics through a picc line or port for a number of years for chronic cases. Despite what either ILADS or IDSA guidelines say, many Lyme patients are remaining sick. Many turning to natural or alternative treatments or using both western medicine along with other homeopathic remedies and alternative treatments.
Growing Bartonella: What Works Best
Ying Zhang, MD and his colleagues at Johns Hopkins show that rifampin and azithromycin are the strongest agents. These are followed closely by doxycycline, methylene blue, oregano oil, and ciprofloxacin. In his experiments he did not study rifabutin, minocycline, clarithromycin, or levofloxacin. The following combinations of antibiotics are in the same family: rifabutin and rifampin, minocycline and doxycycline, clarithromycin and azithromycin, and levofloxacin and ciprofloxacin. If one member in a family works well the other one is likely too so clarithromycin, minocycline, and levofloxacin should work well too.
Antibiotics For Lyme Disease Treatment
Every year, a campaign is launched in the media to raise awareness of what Lyme disease is and what its effects may be. It should be emphasized that Lyme disease can consequently lead to inflammation of the encephalitis and meninges. In the spring and summer period, when the most ticks are found in forests, parks, and meadows, you need to be particularly vigilant and observe your body with the signals they send. If you develop erythema on your skin, you should see your doctor immediately, as this may be the first symptom of a tick bite and possibly Lyme disease. It is not recommended to remove the forceps from the body on your own. Unfortunately, this will not protect us from Lyme disease, if the tick was its carrier. It is better if the doctor assesses the risk of a tick bite.
Infection with Lyme disease of the human body can take several forms, due to the fact that the insects carrying this disease have the form of an oval spirochete without a cell wall, in the form of a cyst, and as spores. If a tick bites a persons skin, Lyme starts living inside the cells of the human skin and is also able to cross the blood-brain barrier in a short time. This is a big problem when treating patients with Lyme disease.
Most often, Lyme disease is identified in:
- Connective tissue skin, tendons, walls of blood vessels, including those in the brain
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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 .
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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Antibiotic Treatment For Early
The first line of treatment for early Lyme disease is antibiotics. The most commonly prescribed antibiotics include:
- Cefuroxime axetil
These antibiotics are most often administered orally, though intravenous administration is necessary for some patients. Programs are typically 2 weeks long but can be as long as 4 or more weeks.
The Centers for Disease Control and Prevention and the Infectious Diseases Society of America maintain that most cases of Lyme disease clear up quickly from a short course of antibiotics. However, as you will see later in this article, there is much evidence showing that Lyme that is not detected early can actually be very difficult to treat and that even early treatment can be unsuccessful. The presence of coinfections can also complicate the treatment process, again emphasizing the need for comprehensive testing at a specialty lab.
Finally, as acknowledged by the CDC, some Lyme patients experience ongoing or recurrent symptoms despite having received treatment for Lyme. These patients are said to have Post-Treatment Lyme Disease Syndrome . Is this caused by untreated coinfections, persistence of Bb , permanent damage, or an as-yet unidentified immune system problem? The jury is still out, but all may be possible.
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Chronic Lyme Dos And Donts
Chronic Lyme disease is an ongoing Borrelia burgdorferi infection that can involve any body system or tissue. The infection produces a wide range of symptoms and signs, which can be debilitating for some patients. Common symptoms include severe fatigue, migratory musculoskeletal pain, headaches, and impaired memory. Unfortunately, chronic Lyme disease is complex and often misunderstood, which means that many patients will struggle to obtain the care they need to regain their health. Every patient concerned about Lyme disease and tick-borne illness should know the following.
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Picc Line For Lyme Disease:
PICC stands for peripherally inserted central catheter. Inserting a PICC line is a common procedure in which a thin, flexible tube will be inserted into a large vein in the upper arm. The tube will be threaded through the vein until it rests just above the heart. A technician will use a numbing agent so there is no pain and the tube will be guided through the vein with the help of ultrasound and/or X-ray. A PICC line can stay in place for several weeks or months without needing to be changed or taken out. It is a more effective way of delivering IV antibiotics into your body if you intend to be using them on a regular basis. The placement of the tube just above the heart allows for a quicker response time for medications and nutrients, etc. If done properly, once the line is in and the initial discomfort settles, it shouldnt be at all noticeable.
Each infusion with a PICC line will take anywhere from 30 minutes to an hour and a half and can be done at your own home either on your own or via a visiting nurse. Otherwise, infusions will be done at a hospital infusion lab or doctors office. PICC lines require regular cleaning by a nurse, either in home or at a facility.
This procedure should be taken seriously, and adequate discussion and caution should be used when considering a PICC line with your doctor.
PROS:
CONS:
Please check out this website, which has detailed information regarding PICC Lines.
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
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Complementary And Alternative Therapies
You should never treat Lyme disease with complementary therapies alone. Only proper antibiotic treatment can cure the disease and avoid complications.
Newsletters and Internet sites have cropped up in recent years advertising untested treatments to people with symptoms of post-Lyme disease syndrome or so-called “chronic Lyme disease” who are frustrated with standard medical treatment. Some remedies may be dangerous and ineffective. Always tell all of your doctors about the herbs and supplements you are using or considering using.
Azlocillin As A Potential Treatment Against Borrelia
Stanford researchers that identified azlocillin as an effective antibiotic against stationary phase Borrelia in culture in 2016 performed another study in 2020, but this time with mice. Azlocillin at relatively low concentrations eliminated stationary phase Borrelia. Cefotaxime required higher concentrations and only killed 80% of stationary phase Borrelia. They also determined that the combination of azlocillin and cefotaxime was more effective at killing Borrelia persisters than azlocillin alone.
They published their findings in the paper Azlocillin can be the potential drug candidate against drug-tolerant Borrelia burgdorferi sensu stricto JLB31.
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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.
Are There Alternative Treatments For Lyme Disease
There are a variety of alternative treatments aimed at patients who believe they may have Lyme disease. But the effectiveness of these treatments is not supported by scientific evidence, and in many cases they are potentially harmful.
Bismacine, also known as chromacine, is an alternative-medicine drug that some people use to treat their Lyme disease.
The Food and Drug Administration warns that people should not use this injectable product, which has reportedly caused hospitalization and at least one death. 70563-1.pdf” rel=”nofollow”> 6)
In addition, the FDA notes that bismacine contains high levels of bismuth, which can cause heart and kidney failure.
Other alternative treatments include oxygen therapy, light therapy, and a variety of nutritional or herbal supplements. But there is no evidence that these treatments are clinically effective in the treatment of Lyme disease.
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Where Are Ticks Found
Ticks are found throughout the UK and in other parts of Europe and North America. There are a high number of ticks in the Scottish Highlands.
They can be found in any areas with deep or overgrown plants where they have access to animals to feed on.
They’re common in woodland and moorland areas, but can also be found in gardens or parks.
What To Expect With Medication Treatment For Lyme Disease
You might have some side effects from both the disease and the medication treatment. Your doctor might suggest other things to make you feel more comfortable. Antidepressants and pain relief treatment may help. You might also be asked to do physical therapy, stretching or exercises or change your diet.Some people still have symptoms of Lyme disease after being treated. This is call post-Lyme disease syndrome. Doctors don’t know why some people get it and others don’t. It usually makes you feel tired and have sore muscles. Using more antibiotics doesn’t help, but other treatments may help you feel better.
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How Long After Starting Antibiotics For Lyme Do You Feel Better
Even though most cases of Lyme disease can be treated with antibiotics for two to four weeks, patients may occasionally experience persistent pain, fatigue, or difficulty thinking that lasts for more than six months after treatment.
Traditional antibiotics can cause discomfort for up to 20 of patients for up to two weeks. Long-term treatment of LYDIA is recommended. Despite its short duration, a new study shows that short-course treatments can be effective. According to the CDC, there are approximately 300,000 cases of Lyme disease each year. Antibiotic therapy resulted in multiple complications. The study found that four patients had serious reactions to ceftriaxone, three of which required hospitalization for hives and respiratory distress. Despite the fact that the study will undoubtedly fail to quell those who believe in prolonged therapy based on a patients symptoms, it will provide further evidence that it is ineffective.
There is a lot of evidence that Lyme disease syndrome is a serious health issue for many patients, but we dont know what causes it. There is speculation that bacteria that have resisted antibiotic treatment persist in the body. Some people believe antigens on the spirochete are inflammatory, which causes some symptoms to appear.
Additional Antibiotic Combinations Against Chronic Lyme
Following up on previous results identifying disulfiram as a top hit, researchers wanted to perform studies on disulfiram in combinations with other antibiotics and additional combinations to determine the most effective. In 2020, the paper Evaluation of Disulfiram Drug Combinations and Identification of Other More Effective Combinations against Stationary Phase Borrelia burgdorferi was published. Antibiotics used in combination were either traditionally used antibiotics for Lyme disease or antimicrobial compounds with strong activity against stationary phase Borrelia.
Disulfiram in two-drug combinations was not as effective as cefuroxime + clarithromycin or cefuroxime + nitroxoline. In three-drug combinations with disulfiram, disulfiram + cefuroxime + nitroxoline was most effective, followed by disulfiram + cefuroxime + nitazoxanide. Removing disulfiram from the three-drug combinations, cefuroxime + clarithromycin + furazolidone, cefuroxime + nitroxoline + furazolidone, and cefuroxime + nitazoxanide + clarithromycin was significantly more effective than the disulfiram combinations.
Unfortunately, nitroxoline and furazolidone are not available in the United States, but the combination of cefuroxime + nitazoxanide + clarithromycin is readily available. It is important to note that these studies were performed on cultures in a laboratory, and benefits may not directly translate in animal studies or humans.
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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.
Symptoms Of Post Treatment Lyme Disease
- Include severe fatigue, musculoskeletal pain, & cognitive problems
- Can significantly impact patients health and quality of life
- Can be debilitating and prolonged
Our research indicates the chronic symptom burden related to PTLD is significant. Although often invisible to others, the negative impact on quality of life and daily functioning is substantial for PTLD sufferers.
The chronic symptom burden related to Lyme disease is considerable, as shown on the left side of the graph above, and statistically significantly greater than the aches and pains of daily living experienced by the control group, on the right.
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What Factors Determine How Patients Respond To Treatment
To find out what made some patient substantially improve or become well, we turned to our academic partners at the University of California at Los Angeles who specialize in artificial intelligence and machine learning. Their team looked at 215 features related to diagnostic factors, treatment approach, duration of individual antibiotics, alternative treatments, symptoms, type of clinician, and functional impairment to identify the 30 top predictive features for treatment response . Most of the top 30 features identified in their study related to chronic Lyme disease treatment , symptom severity , and type of clinician treating Lyme disease. We analyzed three of these factors associated with treatment response:
- Treatment approach
- Treatment durations
- Type of clinician overseeing the patients care
