Is dapsone effective against Bartonella?

I can't seem to find any info regarding its efficacy against bartonella (no studies using it on Bartonella). Ying Zhang from John's hopkins did several studies using doxy, rifampin, azithromycin, ciprofloxacin on persister and biofilm bartonella, however, there aren't any with dapsone.

The reason i'm asking, is that Dr. Richard Horowitz uses Dapsone for Lyme persister and biofilm for, however he never mentions, does it help with Bartonella.

I have solely Bartonella (no Lyme or Babaesia or others like Ehrlichia, Mycoplasma etc.). My main symptoms are neuropsychiatric ones (Depression, Anxiety, OCD, intrusive thoughts, cognitive deficitis). I have tried rifampin, doxy and azithromycin for months now, but the infection keeps returning. It might mean that i need to do years in terms of therapy with antibiotics, but i have no money to extend it for that long (who has?). Bartonella can take up to 24 months to cure with these antibiotics, that's because they address the persister forms and biofilm not very efficiently.

If Dr. Horowitz can achieve remission of up to 2 years in lyme only infected patients with double Dapsone + doxy + rifampin for 2 months, i'd give it a try honestly, if it can help Bartonella the same way.

So my question is, are there any people who have tried Dapsone for Bartonella and what were the experiences?

I know about MB, never tried it, didn't think it would be that effective + i'm not sure about the side effect profile (serotonin syndrome and possible hemolytic anemia, if you have G6PD gene defficiency (i have not checked it)). It is used anyway with dapsone, as it should prevent methemoglobinemia, Dr. Horowitz uses it.

50 mg x 2 a day of MB is probably safe, as used by a lot of LLMDs, but this dose won't really make a difference i suppose, you would need 400-500 mg of methylene blue a day to really feel a fast and significant effect, at which it probably is not safe.

However, i'm not sure it will be enough to eradicate this stubborn infection. Bartonella is brutal in its neuropsychiatric symptoms, i'd rather experience some pain in my joints, like from Lyme, than have to deal with paranoia, anxiety, constant mind ****ing etc.

It seems that achieving a long standing remission or even possibly a cure is possible only if you pump abx for years with this infection, even if it is the only thing you have (no lyme or babesia). And it seems that no less than 4 drugs is required, which puts a serious weight on the sufferer with side effects, cost of treatment (which with insurance companies denying these illnesses means that you have to go out of pocket) and damage to vital organs like liver and kidneys.

At this point i just don't know what to do, i've used rifampin + doxy + azithromycin for 6 months, and when i stop, within weeks i feel as if i didn't have a day of therapy.

the problem likely lies in the persistent and biofilm forms of bart, which are not really killed by rif, doxy and azithro.

After reading quite a lot about these microbes, i've come to the conclusion as a patient, that bartonella is the same as treating tuberculosis, which can be treated in 6 months only because of persister drugs like pyrazinamide and dapsone (in case of leprosy).

I was in denial prior to this, thinking that you can get better on only doxy + rif + azithro, but doing so requires years of therapy, as if you were treating drug resistant tb, which can take up to 18-24 months to treat. I have yet to find a doctor who will put me on pyrazinamide, which i'd like to try, either that or dapsone, as i don't think i'd want to deal with this infection for another year or so.

i'd like more studies on persister drugs on bartonella, i know some of them can be quite expensive (like daptomycin), but we need cheap and effective solutions.

You ever thought about using rifabutin instead of rifampin? Dr M believes it is much stronger and it penetrates tissues 20-50X better. Changing the combination to Clarithromycin + rifabutin + minocycline seems like it could be more effective and shorten treatment time.

I can't comment on Dapsone but I can comment on PZA (Pyrazinamide).

I have been fighting Lyme / Babesia and Bartonella (mainly) since 2018. I have been on multiple combinations of drugs and have recovered to about 90% of my former function. My Babesia testing via FISH is negative and I have only Bartonella symptoms remaining. As good as I feel the symptoms return within hours of stopping my meds. My LLMD is very forward thinking and agreed to try a new protocol with me consisting of Zithromax / Rifampin / Pyrazinamide and Mepron. I have been on PZA for a month now and can give some feedback. It feels to me that PZA has dramatic activity against Bartonella. For the first few days I was on the new protocol I felt a little tired compared to normal and was sleeping A LOT. I have had bad insomnia since this all started and adding in the PZA to my protocol helped my sleep a lot.

On day 8 it hit me like a ton of bricks and I had a bad herx reaction. My symptoms returned with a vengnce and my eyes especially were killing me (I was using ice packs on them due to the pain). My eyes are one area that my normal protocols I had been on for the past 2-3 years could never seem to help. I won't lie - I wanted to quit the new protocol and go back to my comfort zone. I would recommend backing off the PZA if you encounter this but I decided to push through it and used the salt baths and alka seltzer gold to reduce the herx. I found some relief with these treatments and over the course of 4-5 days I began to feel better. With the herx my sleep was again very disturbed and disrupted. I began to improve and consulted with a LLMD who told me he felt this was a herx (he was right). I did note an increase in floaters with this herx as I suspect the die off caused a major cytokine response in my body. I kept track of my symptoms on a calendar and about a week later I got hit with another herx again but this time it was much less severe.

At this point I am about a month through my 2 month plan of treating with PZA and can say without a doubt it is very active against Bartonella (at least for me). There has been a lot of chatter on the forums and online about the danger of liver toxicity with PZA so I will include some interesting notes about that as well. My LLMD wants me to have CBC done every other week. Well I got my first set of results back and something strange happened. My liver enzymes levels were totally normal and were back to the levels they were before I began any treatment at all 3 years ago. My normal lab results are a high normal level of AST and ALT. On this new protocol they were total normal and dramatically lower than my Bactrim / Rifampin / Mino / Mepron protocol. Figured this was an interesting finding and one that other posters would be interested in.

My plan is to finish the 2 month protocol with PZA and then transition into Methelyne Blue to further address the persister Bart (if necessary). I can say that there is no doubt that I have made more progress on PZA than any other previous treatment (especially my eyes and personality). I feel like my old self and content.

Sure. My main LLMD is Dr. FN but lately I have also been consulting over the phone w Dr. MR. Dr. MR is no longer doing phone consults and you have to fly to Seattle to see him. Dr. H out of NY is the pioneer for a lot of these treatments and can probably help you if you are interested in trying them out.

Myerstown