Azithromycin - 2*250 mg or 1*500 mg a day?

Hello!

Me and my doctor are not completely sure what is best, to take Azithromycin twice daily (2*250 mg) or once daily (1*500 mg). I'm taking it together with Minocycline and Bactrim currently for Borrelia and Bartonella. 2*250 mg gives a more even level in the blood (blood half life is short) and is perhaps better for preventing resistance, but 1*500 mg perhaps goes better to the brain.

Which dosage do you use? What would you recommend? Do you know of other doctors opinions on this?

Thank you in advance!

/J

Thank you for the quick reply.

Unfortunately the long half life is only for the tissues. The azithromycin moves quickly to tissues and concentrates there, and the half life in blood is therefore much smaller, around 4 hours in the following study:

http://aac.asm.org/content/57/4/1736/F1.expansion.html

Anyone else with input?

tissue half life is what you need with lyme. disseminated lyme is a tissue disease, lyme likes to stay in tissues not in blood.

so yeah, azithromycin is good because it has huge tissue half life

on its own azithromycin is a weak antibiotic. it is used to boost antibiotic effectiveness in combinations. also it is used to prevent bartonella from becoming resistant to monotherapy. for eg bartonella quickly becomes resistant to rifampin alone. you should NEVER use one antibiotic to treat chromic lyme, that is a really bad idea, for many reaons. coinfection antibiotic resitance, lack of effectiveness to mention two.

Thank you mpost!

I use it for Bartonella together with Bactrim and Minocycline. Soon we will replace Bactrim with Rifampicin.

My question is, for Bartonella protocolls, the most annoying bug from resistance point of view, is it more common to take 250 mg twice a day or 500 mg once a day?

I am curious about this too, anyone else have any feedback on any real difference between 1x500 or 2x250. most of the dosages noted online for zithro are one 500mg PO

anyone doing zithro 2x250?

thanks

I'm still thinking about the half-life - as from what I've read - it is blood levels...not tissue.


https://www.verywellmind.com/medication-half-life-380031

A medication's biological or terminal half-life is how long it takes for half of the dose to be eliminated from the bloodstream.


https://www.nottingham.ac.uk/nmp/sonet/rlos/bioproc/halflife/index.html

"We usually consider the half life of a drug in relation to the amount of the drug in plasma. A drug's plasma half-life depends on how quickly the drug is eliminated from the plasma. "


https://www.news-medical.net/health/What-is-the-Half-Life-of-a-Drug.aspx[url]

"The elimination half-life of a drug is a pharmacokinetic parameter that is defined as the time it takes for the concentration of the drug in the plasma or the total amount in the body to be reduced by 50%. "

Dr J prescribes it as 500 mg doses (can't remember though if that's once or twice daily - I would think twice daily as he doesn't skimp on antibiotics...)