Does Doxy and Zithro beat Bartonella?

According to Dr. M.R. (Seattle LLMD) - for Bartonella treatment - Tier 2 (Tier 1 being rifampin or Flouoroquinolone based treatments) - you combine a tetracycline with a macrolide.

So, doxy (tetra) plus zithro ( macrolide) would be a treatment.
dosage: zithro 500 mg twice daily plus doxy 100 or 200 mg twice daily.

I don't think that many people do that protocol, though. The most often prescribed one is the Rifampin based treatment.

The Rifampin (600 mg once daily) is paired with either minocycline or zithro.
Doxy can be substituted for mino but, rifampin decreases doxy level in the blood.
Clarithromycin can be substituted for zithro, but rifampin also decreases clarithromycin blood levels.

I can't answer how long treatment will take...it's different for everyone.
.

What if i'm on zithro 250mg 2x a day for a total of 500mg, but not 500mg 2x a day? how effective is 250mg 2x a day?

I started on rifampin, doxy, zith and tinidazole. Due to the summer sun, my LLMD removed the doxy and replaced it with bactrim. I take Zith (500mg) once a day on Monday, Wednesday and Friday. On Sunday I only take Diflucan to control yeast. I've been doing this for 7 months and the improvement is very slow but it is there. I've had bart for at least 15 years. My LLMD believes Rifampin is one of the best drugs for bart.

From what I've read, the flouroquinolones (sp?) are very effective - but come with risks I don't want to take.
Even my LLND won't suggest them for my bart treatment - he will prescribe Rifampin.

But, if you're getting better on the combo of doxy and zithro - albeit slowly, maybe stay on it until you plateau? How slowly is slowly? We talking monthly improvements...or?

Dr. M.R. suggests 500 mg twice daily of zithro, but when I was on zithro with my doxy - a LLND only gave me 250 twice daily.

sorry i was delayed in answering this - I read it but didnt have a chance to post until now.

I am a good example of this medicine combination

i had bartonella and lyme, and began my treatment with doxy and zithromax. what dose of doxy are you on? I was taking doxy 200mg twice a day and zithromax 250mg twice a day. I do not see a need for 500mg twice a day of zithromax because the medication remains in your system for a much longer time than the average antibiotic (which is why they have the zpack - 500mg daily for 3 days, etc)

Although i started off with this combo, i couldn't handle the doxy anymore so my dr switched me to bactrim. I do not see this medicine mentioned much on the forum. That is what killed the bartonella for me. it was a wonder drug combination. I took bactrim DS 1 tablet twice a day plus the zithromax 250mg 1 tablet twice a day, in addition to other herbals. Are you taking any herbs? are you detoxing? these are also very important to aid you in treating and beating these bugs!

Yes, but you need to use Rifampin WITH something else, like Azithro.

Margaret

Hi Revive,  I too was on azithromycin and rifampin for bartonella.  Now I remember we were posting about that.  How do you like the biaxin?  I actually self switched myself from azithro/rifampin over to biaxin/rifampin 2 weeks ago, and I'm glad I made the switch because it is working MUCH better. 

I think azithromycin is weak compared to clarithromycin (Biaxin), do you feel the same way?  Clarithromycin is proven to be more effective against lyme, and doctors are also saying it's more effective on Bart too... Maybe it's the higher doses?  But it is a different macrolide than azithromycin. 

I feel... My bart symptoms are done!  Azithro/rifampin didn't cut it for me, I'm not sure why, maybe because i was only dosing once per day?  (600 mg rifampin, 500 mg azithromycin all at once).  Now I'm dosing twice per day and I find it works far better ( 500mg clarithromycin / 300 mg rifampin twice daily). 

Do you mind me asking your doses?

Also... I just wanted to say be careful not to withdraw bart treatment too soon!!! This happened to me twice already, where I had no bart symptoms and stopped treatment prematurely!  Remember a non-fluroquinolone treatment like rifampin/clarithromycin needs 6 months. 

I think doxy/azithromycin could beat bart... But I haven't actually heard from anyone that beat bart using that combo.  There are better combinations... The rifampin/clarithromycin is supposedly the best known antibiotic combo for bart without having to use the fluroquinolones.  This information was actually just recently released too. 

afiya4health - 8 months isn't a long time to get rid of bart....

Why go slowly you ask? Because you don't want to suffer immensely with a long-lasting herx.

Not only are severe herxes uncomfortable, painful, etc....but they are not good for the body - ie. inflammation...etc.

Some can even be life-threatening (I know - not common)

Girlie... I hate to say but Dr.MR is not the expert we are looking for in treating bartonella. He outlines some great abx combos that are used among him and his colleagues that treat lyme, bart, and babesia. But his focus is treating them all. The doc on this webinar I am posting specializes in bartonella treatment and has probably the most experience, he has seen so many details in treating bart in his patients compared to other docs I have read about and everything he talks about matches my own experience with it too. But I for one have had bart relapse twice, and when bart isn't focused on with lots of effort and not treated long enough it relapses. His thinking and his posts suggests bart treatment just needs 4-6 months and he "treats until bart symptoms appear resolved". This is not good enough in my opinion and is setting up the stage for an incomplete treatment like it did for me.

I HIGHLY suggest anyone on this forum visit the following page:

http://www.galaxydx.com/web/

Check the free webinar that is just recently published which can offer probably the best understanding of bart that I have come across. Essentially it infects BOTH collagen and small blood vessels... And this is the cause of the symptoms depending on where it is. It can cause the POTs, low CD57, can cause band 41 on the Igenex lyme test. I learned a few things about bart the past few days.

The best treatment is to START with clarithromycin for 1 month, then add rifampin at half dose for the next month, and then double it. So for example go 500 mg clarithromycin BID (twice daily), then the next month you add 300 mg rifampin BID, then he increases to high dose of 600 mg BID rifampin. So then it's 500 mg clarithromycin BID and 600 mg rifampin BID. This is a high dose but apparently he has high cure rates with this method. Also something should
Be taken for biofilms like lumbrokinase and serrapetase as bart can cause fibrin deposits in the blood stream and hide in these. This doc also suggests not using quinolones as they can cause damage to the telomers of our DNA.

Bart is NOT an easy but to treat. This time
I'm not going to stop treatment, my treatment failed like 3 times already! And just recently I did 500 mg azithromycin, and 600 mg rifampin for 6 months! It just didn't cut it, now I'm going to follow his
Protocol.

ALSO ... Another interesting point he makes is Elevated liver tests are often the result of dead bacteria, and eventually drop with treatment! It's interesting. Doxy is said to not be that effective against bart. Lol I can go on and on about what I learned.

Post Edited (LymePickle) : 8/5/2015 11:26:41 PM (GMT-6)

Girlie.. I'm going to talk to Dr. R about it, and if not I will talk with Dr. C about it.  I think Dr. R is going to stick with saying it should be gone in 6 months, but for me it is not. 

I also talk with another of Dr. C's patients, and he said he did do the 600 mg rifampin twice daily with Dr. C for a total of 2 months.  So he is open to prescribing it.  It all depends if your liver can keep up... You could say this patient is one of the more "ambitious patients", he even did a 5 drug treatment for some time of mino+clarithromycin+rifampin+septraDS+rifampin!  He herxed for some time, but I think he just didn't treat long enough.  I think treating for a long enough duration of time is more important than exactly how many abx you use.  You will obviously want some supportive treatments as well, since rifampin boosts metabolism of not only other drugs, but also hormones!  So hormone support might be a concern.  And it's also important to add in vitamin C and antioxidants. 

Yes, the more I think about it, the vast bulk of my symptoms have always been bart.  I think those symptoms you mentioned are also symptoms I have had and are bartonella related as well.  I even have these lines on my finger tips... Loss of collagen, which is bart.  I had a bad bart herx which feels more like tendon pain etc... again it was bart.

You could ask for 100 mg mino BID, 500 mg clarithromycin BID, and 600 mg rifampin BID.  But that's taking quite a bit of abx, maybe too much.  Or you could just ask for 100 mg mino BID, and 500 mg clarithromycin BID... Maybe for a month.  Then introduce the rifampin with the mino and the clarithromycin... Or just drop the mino and introduce the rifampin.  Or do mino + clarithromycin + just the 600 mg once daily of rifampin?  The change over to just the clarithromycin + rifampin?  Remember bart is mainly "small vessel disease", bacteria that go in the small bed capillaries and then to the red blood cells and back again. 

For me personally I just want to drop the mino and do the clarithromycin and higher dose rifampin.  So far I seem to be tolerating it.  I am just experimenting with a 900 mg dose daily right now. 

Also... You do realize there is a good chance that your elevated liver enzymes could actually be from your liver processing the die-off? 

Did you watch the webinar on bartonella?  I think it's very good. 

To Girlie:
From what i read Bart can be treated within 4-6 months. It's here in this post where i'm hearing (as stated by Lyme Pickle) that 4-6 months isn't correct even though that's what i've been seeing here on healing well and mdjunction.
I see no reason why it should take 8 months to get rid of it for me because 1) it's the ONLY infection i currently have 2) My Lyme doc has been treating all infections since the beginning (using multiple abx combos) so it technically has been treating it for 3 years (obviously not targeting it completely) and 3) Since its the only infection i have i think its ridiculous to think it should take almost another year to get rid of this one thing.
This is just my thinking, correct me of i'm wrong/mislead.

Rikky1:
Thank you but i've heard some mixed reviews online. I hear that for some A-Bart doesn't make them herx. Is it bad if it doesn't make you herx?

Lyme Pickle:
Why do you think 4-6 months is too short in treating bartonella? you said your treatment failed 3 times so how long have you been treating it for?

To all, so does Rifampin actually work best or is it just the most popular choice for bartonella? Because i want something that's going to get rid of Bart and from what i'm hearing its sounding more like the latter(aka not the best choice).

afiya4health...

4-6 months is too short.  The only place I found this was from Dr. MR and his online treatment manual.  He says 1-3 months with fluorquinolones, and 4-6 months with other treatments.

I relapsed first time after 4 solid months of treatment, it was actually a little longer.  But I had no symptoms.  Then I treated again hard for 2 months and relapsed yet again.  Now I have been treating 6 straight months... and it should be done by now!  But it's not!   I don't know why it's not finished, maybe it's resistant?

With the new webinar... It is confirmed that 6 months is the ABSOLUTE minimum.  A graph is shown of one patients antibody response through treatment, and the last of the bartonella antibodies are not released until around the 6 month mark, then by 6.5-7 months of treatment they are gone completely.  But he has an argument that bart might persist in biofilms.  ... ALSO... Bart is different than lyme in that it requires continous treatment... Hence if you miss a single dose of abx, you could potentially be back at square one.  So it's not an easy infection to treat.  I myself have taken no more than 3 days off treatment... In the past 6 months I haven't missed a single dose!!! But i only dosed once per day... 600 mg rifampin, 500 mg azithromycin. 

You have to be careful with bart!  It actually takes a certain kind of person to persist through the treatment and not miss any dosing.  Don't think bart is easy to treat because it's not.  But cure has been acheived in patients... Some argue the cure rate is 90% or higher IF and only IF the patient gets the right treatment.