Dr. Feng research: Daptomycin + Doxycycline + Cefoperazone/Ceftriaxone

I was wondering if y'all had come across this study by Dr. Feng that showed eradication of Borrelia persisters using Daptomycin + Doxycycline + Cefoperazone/Ceftriaxone:

https://www.ncbi.nlm.nih.gov/pubmed/25806811/?ncbi_mmode=std

https://www.jhsph.edu/news/news-releases/2019/three-antibiotic-cocktail-clears-persister-lyme-bacteria-in-mouse-study.html

http://www.discoverymedicine.com/Jie-Feng/2019/03/persister-biofilm-microcolony-borrelia-burgdorferi-causes-severe-lyme-arthritis-in-mouse-model/

It seems like they showed it in vitro, as well as in vivo in mice.

I know a lot of people are on the Dapsone bandwagon these days but I'm just wondering why this hasn't been made a bigger deal (seems like it was published a couple of years ago) / why it's not being used (or is it?)? Have any of you tried this combo before?

Quin said...
Yes, this is well known, and generally considered impractical because daptomycin and cefoperazone/ceftriaxone have to be given intravenously.

I am instead taking valproate + minocycline + cefdinir, which has a similar mechanism of action, but can be taken orally. The limiting factor is how badly this makes me herx.

But there are a lot of llmd’s who offer IV abx - not sure that’s the reason - if it is indeed a good protocol why wouldn’t they do that protocol.
(Dr J, Dr H .... etc)

Quin said...
Yes, this is well known, and generally considered impractical because daptomycin and cefoperazone/ceftriaxone have to be given intravenously.

I am instead taking valproate + minocycline + cefdinir, which has a similar mechanism of action, but can be taken orally. The limiting factor is how badly this makes me herx.

Just curious, how did you / your doctor decide on Valproate as the Daptomycin substitute? It's an anticonvulsant (vs. an antibiotic) so I'm just wondering how it would work instead. Thanks!

Quin said...

Girlie said...
But there are a lot of llmd’s who offer IV abx - not sure that’s the reason - if it is indeed a good protocol why wouldn’t they do that protocol.
(Dr J, Dr H .... etc)

I dunno... Why don't you ask Dr J next time you see him? Does Dr J really have patients coming in 2 to 3 times a week for IV antibiotics? Would you be able to travel to Washington DC that often?

Also, the mice were infected for 90 days, and then treated for 30 days. If you've been infected longer than that, you're going to have to deal with the biofilm colonies, which I'm finding very hard to get rid of. I couldn't tolerate 30 days of what I've been taking, and backed off after about 2 weeks because the herx was so bad.

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Yes Dr J has people coming in to the clinic for IV abx. Or patients administer it at home if they don’t leave in or near DC.

The people who do IV but don’t live close to the clinic get set up to do the IV in their city - and go to the clinic approx every 4-6 weeks for testing.

ChickNorris said...
I did this protocol with my LLMD. Just did it at home with IV meds. It is what pushed me into remission. I was on the full protocol for like 2 months or so after having treated with IV meds for nearly two years.

How long did you herx? I did valproate + minocycline + cefdinir, and had to stop after 2 weeks because the herx got so bad. I ached all over and barely got out of bed.

So you took invanz (ertapenem) instead of cefoperazone or ceftriaxone. Ertapenem is also a beta-lactam antibiotic, so it works similarly to cephalosporins.