Rifam+Doxi for Bart please help

I took the antibiotics together.
Sometimes I was taking 5 + different ones at a time.
That is how the Lyme docs prescribed them.
They are meant to work together

Hi, perhaps you guys are right, but I m taking them separately. Morning Rifampin 300mg on empty stomach, then 2 hours later Mino/Doxy with breakfast, the same evening. I read in the Rifampicin prescribtion that taking it with food is reducing the efficiency by 36 percent. In any case since half life is around 4-5,5 hrs, there comes a combining effect, but it can be stronger when taken at the same time.
I have only once taken 3 abx same time, and I had a pain in my liver/galdbladder so I prefere to take them at separately.
For LitleBee - I took the same combination like you for 2 months last year in october/november. Now i m taking it in combination with azitromycin or clarithromycin and I find it more effective. I dont know why, but it seems it is hightening the effect. That is my experience, but I cant explain why. Now 500mg once a day and could be perhaps even more effective to take 2 times per day but. I dont want to overdo it.
Coming back to Girlies point, yes perhaps I should try to take them together, and see maybe this time I will be able to tolerate it. But Girlie, which 5 different kinds of abx have you taken simultaneously?

Bhava I forgot to tell you Im doing the same, first Rifamp on empty stomach and then with breakfast Doxi....
But that way I considered I was taking together.

Garzie:

“ I decided to avoid pulsing rifampicin - and use rifabutin for pulsing instead.”

Dr J’s words were: “ Rifabutin is “cleaner”

Dear Little bee,
if you have an early and mild bart perhaps shorter duration could be possible, but if you are having chronical or neurobartonelly like me than 2 months is not enough. It is important to accept it. I did not, and I did shorter duration therapy, moreover I was misled by one unqalified doctor who told me to stop taking abx, and then I had relapse. It became clear after a week or so that symptoms are coming back. Yet I have continued without abx for 2 more months and I was really in a bad shape.

Slowly I came to this 3 fold combination through my experience - indeed rifampin and mino as twofold combination seem to be too weak to eradicate it. Now adding clarithromycin (I run out of azitromycin which is harder to get for me), I can it is giving stronger herx or the effect is more concrete. I m ready to continue until my symptoms will be gone, this time not stopping.

Bart is said to be able to form abx ressistence - contrary to lyme. But I dont want to take that risk with bart. I think it is good that you are on Rifampicin, because as it was said in other treads, and which is also in many other sources it seems to be a major agent against bart.

Rifabutin might be more efficient also perhaps it has longer half life and so can stay longer active in the system, I guess. But for its hard to get Abx. There are other eventuall options for bart like

I had a similar experience like Quinn last year. I was convinced its over and even my IgG was negative. This is my experience.

Good luck and best wishes
B

as far as i know - the same issue does not exist with rifabutin - at least i have never read anything to suggest it

to aid your discussions with your LLMD - here is an example of such a report in the scientific literature

report said...
Although rare, several reports have been published describing the post‐rifampicin acute renal failure dating back to 1976. 2 Most commonly manifesting as acute tubular necrosis (ATN) following re‐administration of rifampicin;

source: https://www.ncbi.nlm.nih.gov/pmc/articles/pmc9771787/

in their defence - although very serious - and can lead to permanent kidney damage - it is a rare event - so your LLMD may have treated many lyme patients with pulsed Rifampicin and never seen this happen before - and so it may appear safe to them based on their experience.

i don't think its a case of never taking it again in your life if you have ever taken it - the risk of the reaction likely reduces the more time has passed since the last administration.
although rare, some people even get this reaction when taking rifampicin for the first time - it just seems that the risk goes up if you take the drug in a pulsed fashion.

in terms of putting this risk in perspective - its worth bearing in mind that there are risks associated with taking any drug and other drugs are capable of causing the same reaction.
so doctors do not have a zero risk option to choose - all options have some risk - and the doctors must instead perform a risk vs benefit calculation on behalf of the patient.

i hope its of some help

LitleBee said...
Thank you all for your responses, now Im afraid what my LLMD is doing! I will discuss with him.

Can you please tell me if you can take Rifabutin after Rifampin? There is no trouble with that?

Thanks a lot.

Bee.

Yes you can.
When I was treating with my first Lyme doc - he had me taking rifampin

Then a few years later I switched to a LLMD - Dr Jemsek
He put me on Rifabutin