Pulsed Antibiotics: The Future for Chronic Lyme?

I am working with infectious disease specialist, Dr J (SC) and am excited to share his concept of "pulsed antibiotic therapy" and how he is treating me and hundreds of others, successfully, For the first time in over 1 1/2 years I feel I am getting my life back.

The 3 major players in chronic Lyme are Borrelia (Lyme), Babesia,and Bartonella. Sure we are also teaming with viruses, yeast, Mycoplasma, and other undesirables but he believes that if you can get the big 3 under control you can eventually get the immune system back into a functional state.

According to Dr J these 3 organisms are almost always present in chronic infections and fortunateley they divide slowly-which allows for dosing antibioitics every other day. He has been treating patients this way for the past 5 years with good results. He uses all antibiotics, orally or intravenously, on alternate days- typically M,W, and F.

I am currently doing Clindamycin 900 mg twice daily intravenously M,W,and F with Azithromycin 500mg, also intravenously. In addition I am doing 1000 mg Artemesinin and Mepron (2 tsp) orally twice daily on theses same days. After one week of this, he had me add in (oral)Bactrim DS, 1 1/2 tablets again M,W, F. I also add Flagyl 500 mg twice daily on Th and F (orally). These drugs are treating Babs, Bart and Lyme forms.

On the days when I am not infusing/taking antibiotics he has me infuse one liter of Lactated Ringer's solution which he feels helps buffer the body (help it be less acidic) and "flushes" the organs.

Every 2 weeks he has me take a full week off treatment to see how I am and this (he believes) allows the immune system an opportunity to regain strength. How you do on the week(s) off allows him to get a glimpse of how well the immune system is recovering. This is a technique he used for years in his HIV patients and I think it makes a lot of sense as a physician.

The key to this disease is not to eradicate every last evil bug- rather it is to get the infectious load down low enough so that our immune system can recover and take over its job. Antibiotics are great but if they are poisoning your livers, and suppressing your immune system they can be counter productive.

I believe the reason some of us do not recover is: the 3 big players are not addressed and the immune system is not brought back.

Regarding the first, it is great to test for co-infections but if negative these tests should NOT preclude treatment. All patients with chronic Lyme should be treated for ALL 3 big players (Bart, Babs, and all forms of Lyme). Demand treatment for all 3. Babesia is the hardest to eradicate ie long term Atemesinin is needed (I'll post more on this).

Regarding the second, the immune system should be supported as much as possible, ie transfer factor?, treating for yeast intemittently, taking breaks from antibiotics. If the immune system is not supported you will keep "chasing your tail."

Thus far, I feel the best I have since becoming ill summer 2008. The best part is that I can sort of get my life back- as I know which days I am infusing. He also has some novel ways to deal with herxing and detoxing (see my next post).

My hope is to get other doctors involved in clinical trials with his protocol. I am meeting with a doc next week here in Boston to see what can happen. If you have a doc that may be interested let me know. It would be great to get some other infectious disease docs involved.

It's time for us docs to stop fighting and start communicating and working together!

Oh - in re-reading your post I see you ARE a doctor, so probably you didn't need to be in a doctor's office for the IVs. I'm looking forward to reading your next post.

Rose

I'm doing pulsed therapy, too, on a smaller scale. The artemesinin I take 2x a day for 3 days, then 4 days off. The Mepron I take 2x a day for 3 weeks, then one week off. The azithromycin is 2x a day every day with no breaks.

Keep Hope - how can you tell how your body is reacting? Have you been doing this for awhile? So far I pretty much feel terrible every day.

Rose

KeepHope,

Thanks for your response. This is all so nebulous. Lyme, babesia, and bartonella cause so many symptoms; the meds can cause symptoms; and a response to the meds can cause symptoms. I'm still trying to understand how I will know if I am having a herx versus just swinging with the cycle of the various bacteria versus reacting to the medication itself. I'm guessing the latter would cause more serious symptoms than the first two.

I started the azithromycin first. Then we added the artimisinin, then the mepron. My doctor starts me on a low dose and I build up over a period of 3 days to the full dose of each medication. Today is my first day on a full dose of mepron. It's difficult for me to tell if I am having a herx reaction, because I felt terrible going into this. I wouldn't say I am worse than usual, but before I started meds there were days when I felt pretty good. Very few in the last 6 months or so. I've only been on meds for a month and a half.

The one thing I know bothered my stomach was the trazadone that the doctor gave me to help me sleep. It did work for the sleep but I had a terrible stomach ache every day, so I quit taking it.

I'm thinking of starting a journal so that I can keep track of my symptoms. Maybe that way I can tell if I'm doing better or worse.

thanks again,

Rose

Currently South Carolina, but the medical board is forcing him to move to DC next month!

I used to think it was a matter of finding "the drug." I now see treatments as a dance. Multiple drugs need to be used against all 3 bugs I think in unison so that the immune system can finally get better- they all 3 drag it down and just when you treat one, another raises its ugly head.

I was certain that my 5 months Mepron/Zothro and 18 months Artemesinin cured my Babesia--- well they didn't. It's in my liver and though I no longer have headaches and vertigo it is dragging me down while trying to treat Bart.

I think the best Bart drug is Levaquin and Dr J is planning to use it IV (which is very nauseating) - but we will pulse it in on M,W, F with drugs for Babesia and Lyme. Rifamipicin and its related cousins are also excellent for Bart. And Bactrim is good for Bart and hits Babs. OIn fact many drugs have some cross cover.

I really do think that the answer is going to be high doses, multiple drugs pulsed alternate days with drug holidays. I plan to work to develop satellite centers so that such treatments can be available to all. Currenly most LLMD's are unable to offer unusual treatments but we can push for research using such therapies.

pcpc - Thanks. I copied your response to show my doctor.

Rose

... if I have a pulse, it's a good day ...

Very interesting post however the protocol leaes little hope for those of us (a huge group) that cannot afford IV treatment.  Any thoughts on oral treatment pulsing?  I stopped antibiotics a month ago and now take an immune supplement call 4Life Transfer Factors TriFactors plus ... it has made a huge difference but Lyme symptoms reappear a week before my period so LLMD suggested I take antibiotics (Zithromax and omniceff - I could not tolerate doxy) for a week prior to period.  I am open to any information you may have on pulsing oral antibiotics.  I'm using A-Bart also during weeks I am not an antibiotics.

What I've observed more recently is it seems more common to pulse cyst-busters (e.g., 1-2 weeks/month, or 2 days/week) than other abx.

LymePickle, what was your regimen for pulsing?

Ya... I've been on abx for way too long, i would say I've been virtually symptom free for the past 2 months now. But as soon as I "test the waters" sort of speak and come off antibiotics so miss a dose, the symptoms come right back!!! It's frustrating.

I think what happens with Borrelia, is persistence, not necessarily resistance. It is a very slow growing germ, but I think it relapses because some germs go dormant during abx treatment! My theory is that we want them to resume their normal cellular metabolism and wake them up again so we can effectively kill them.

Also pulsing abx gives your body time to repair, mobilizes the immune system, and as soon as the germs start their metabolism up again we can stun them with abx and the immune system can do it's work.

That's what tetracyclines like our doxycycline and minocycline do. They bind reversibly to the 30S ribosome which takes RNA and transcribes it into protein. But if you keep the tetracycline on them some of them freeze up and go metabolically inactive only to become active again later. If we give them abx when they are in the middle of a process like reproduction it can kill them.

I don't have a regimen for pulsing yet. I took yesterday evening off all abx (except my Septra DS which is for Bartonella). And the symptoms came back big time, all my remaining symptoms are brain symptoms! The infection lingers in my brain!

So I gave it a shot of 200 mg minocycline and 500 mg tinidazole and totally knocked it back out, I think I actually had a little herx by doing that. No symptoms now since that dose I took in the morning.

But 200 mg minocycline is too much at once!! It gives me a little headache after. And taking so much tinidazole scares me because it could cause DNA damage!

I think the ultimate plan is to go 100 mg minocycline and 250 mg tinidazole every second day. These are also MUCH better tolerated doses. I will just take them on an empty stomach.

That will lower levels down enough so they will resume metabolism, and maybe even come out and think it's safe, then hit them.

I see lots of "cures" done by pulse dosing. Lyme is such a slow growing germ that abx resistance actually is not at all an issue. The issue with lyme is persistence!

Post Edited (LymePickle) : 6/8/2014 6:34:03 PM (GMT-6)

Hi picture of health

What abx or herbals are you taking?

Also as an aside, even the Cowden protocol has points of interrupting treatment and then resuming!

Wow, quite the list. Are you being treated for all of the 'big' 3 infections Borrelia, Bartonella, and Babesia? How are you pulsing them?