Hey Raw Runner! How are you? It's been a while since we've crossed paths here on the forum!
If I were you- and I've done this - print out Dr. Joseph Burrascano's paper, "Advanced Topics in Lyme Disease" and use it as your guide for treatment. (
betterhealthguy.com/joomla/images/stories/PDF/lymdxrx2008-october.pdf)
On page 14, he starts explaining which abx help and which ones don't and what they are best for. Quite interesting to be honest. Here is a bit:
"ERYTHROMYCIN has been shown to be almost ineffective as monotherapy. The azalide azithromycin is
somewhat more effective but only minimally so when given orally. As an IV drug, much better results are seen.
Clarithromycin is more effective as an oral agent than azithromycin, but can be difficult to tolerate due to its
tendency to promote yeast overgrowth, bad aftertaste, and poor GI tolerance at the high doses needed. These
problems are much less severe with the ketolide telithromycin, which is generally well tolerated.
Erythromycins (and the advanced generation derivatives mentioned above) have impressively low MBCs and
they do concentrate in tissues and penetrate cells, so they theoretically should be ideal agents. So why is it
that erythromycin ineffective, and why have initial clinical results with azithromycin (and to a lesser degree,
clarithromycin) have been disappointing? It has been suggested that when Bb is within a cell, it is held within a
vacuole and bathed in fluid of low pH, and this acidity may inactivate azithromycin and clarithromycin.
Therefore, they are administered concurrently with hydroxychloroquine or amantadine, which raise vacuolar pH,
rendering these antibiotics more effective. It is not known whether this same technique will make erythromycin
a more effective antibiotic in LB. Another alternative is to administer azithromycin parenterally. Results are
excellent, but expect to see abrupt Jarisch-Herxheimer reactions."
Of course he goes on to explain much more. It could prove to be quite useful for you and your doc!