Antibiotics combo question (mino, azithromycin, ceftin)

I believe the combo of mino and zith is supposed to be effective against lyme, bartonella, and babesia. I'm unfamiliar with ceftin. I take mino, zith, and flagyl. The flagyl i take as a cyst buster and only for 2 days out of the month. My main abx are the mino and zith.

I have seen those three together as a protocol before....and I also checked with the Drug Interaction checker and no interactions came up.

The penicillins and cephalosporins (Ceftin) work to weaken the spirochete outer covering.
Both tetracyclines (mino) and macrolides (azithromycin) block protein production - which limits the spirochete's ability to grow.


(This information is from the TreatLyme book - LLMD MR)

Thank you all! That is very helpful Girlie, and I'm glad to hear your experience, Hoagie.

I'm debating whether to start it this weekend or next. I'm off abx right now for a gut rest and afraid to be off long -- feeling some tremors and aches return and I hate to let the evil bacteria multiply away. But I just received my burbur and pinella and started it today (just 2 drops), and my gut isn't really settled yet.

I'm so scared to start the new abx (lots of allergies) and kind of want to get it over with. But am I rushing it too much?

It's not new. You're probably right. Next weekend then, I guess. (I don't want to start during the workweek and risk my principal having to teach for me again in case of a reaction on a school day.)

Dahlias said...
It's not new. You're probably right. Next weekend then, I guess. (I don't want to start during the workweek and risk my principal having to teach for me again in case of a reaction on a school day.)

Okay - if it's not an acute infection...and you've had it for many months to years...then waiting a week or so won't matter. If you need to heal your gut, I would take the time to do it...even if it's more than a week.



No, I don't think your 3 week stint with doxy changes anything.

Back again with a follow-up question.

I tried the third antibiotic (it was Cefdinir / Omnicef) and had either a strong side effect or a reaction. I took it twice -- the first time I was hit with what I assumed was a panic attack. The second time, I know it was not a panic attack -- I felt a wave of weakness and then I felt confused and disoriented, had a little difficulty swallowing, and then a few itchy spots on my forehead. Awful feeling. I told the doctor and they told me to take Ceftin instead. I do NOT want to do that. They said there is no other alternative and the other two antibiotics are not enough. (I am supposed to pulse all three, three days a week.)

What would you do?

omnicef/Cefdinir is very good against PERSISTENT borrelia. Sorry the caps but i want this to be clear.

"Using our HTS method, we were also able to identify some cephalosporins that were very active against the persistent forms of Borrelia. Cephalothin, cefdinir, cefotaxime acid, and ceftazidime had a bacterial inhibition value of >98%. Cephalosporins follow a mechanism similar to penicillins for demonstrating their antibacterial effects. However, these drugs are more resistant to the action of β-lactamases. Cephalothin, cefotaxime acid, and ceftazidime are the first-and third-generation parenteral cephalosporins. Cefdinir, however, is a third-generation oral cephalosporin having up to 25% bioavailability.60 A number of cephalosporins have been proved to possess remarkable activity against a number of bacteria, including B. burgdorferi.35"
/www.ncbi.nlm.nih.gov/pmc/articles/PMC4827596/

it is very important to take 3 antibiotics not just two or one and Cefdinir is among the most effective persister drug out there, as you can see from the mentioned study.

Girlie said...

The penicillins and cephalosporins (Ceftin) work to weaken the spirochete outer covering.

yes Girlie but it's a trick, some cephalosporines as this Omnicef, they destroy persisters. They do this because the Borrelia persisters are weird. They are not dormant cysts. The peptidoglycan (component of cell wall) continues to be manufactured inside the lyme "cysts". Nobody really knows why is this, are these "persisters" replicating ? Maybe, maybe not... but still the machinery of cell wall synthesis continues inside the cell, which means the normal penicilin family works against them. Of course you need third generation cephalosporines and more advanced penicilin antibiotics, not just amoxicilin, these newer penicilins are getting deeper into tissues and probably get into the cells.

Let's see what K Lewis had to say in this game changing paper that we now have full access:
aac.asm.org/content/59/8/4616.full

"Cell wall-acting antibiotics do not normally kill nongrowing cells; one possibility is that stationary state B. burgdorferi cultures represent a steady state of growing and dying cells. The ability of β-lactams to kill nongrowing cells was also observed in M. tuberculosis where a combination of meropenem and a β-lactamase inhibitor was able to kill viable but nonreplicative cells (50). The authors speculate that peptidoglycan remodeling continues in these nonreplicating cells allowing for the activity of the β-lactam. This is another possible explanation of the killing of stationary-phase B. burgdorferi that we observed with amoxicillin and ceftriaxone."

So let's not treat these as simple cell wall drugs... It is IMPORTANT to take this antibiotic, along with the other two, so 3 antibiotics, to kill the persisters.

Post Edited (mpost) : 10/31/2017 1:26:29 PM (GMT-6)

a combo that worked really well for me is mino+zithro+rifampin. no penicilin.

or

you can do desenzitization. read this and ask your doctor.
/www.ncbi.nlm.nih.gov/pmc/articles/PMC3242422/

I hate rashes -- so hard to tell the cause. I hope it's not an allergy for you, Girlie.

Mpost, I'm glad to hear of the combination that worked for you. Did you take them daily or pulse them?

I will call an allergist tomorrow. Thank you both!

Thanks.

I went to an allergist and am still allergic to penicillin. (Positive intradermal test plus shortness of breath -- ended the trial.) She thinks the Cefdinir reaction sounds like an allergy, and those two together don't bode well for Ceftin, but she will trial it with me next week if I want to, which I guess I'll do. Fun.

Mpost, she did say that they can desensitize anyone to any medication (in a hospital setting). But then pulsing could be a problem because the allergy returns 24-48 hours after you stop taking the medicine. Interesting stuff.

Incidentally, she also said that she's a little concerned that pulsing could increase the likelihood of developing more allergies in a person prone to allergies.

I kind of think I should take mino daily and pulse the azithromycin until I can add a third antibiotic, but I'm hesitant to do change things up without a doctor's approval. (Plus, I'm not sure how many refills I have.) This schedule seems too light.

My instructions are very clearly to pulse the Cefdinir or Ceftin, exactly the same as the other two.

I completely respect your knowledge but I can't really wrap my foggy brain around this stuff.

mpost said...


You are confused. Cefdinir / Omnicef must not be pulsed. Do you know what pulsing does ? What is the theory behind it ? The idea is the spirochetes turn to persisters as soon as they sense too many dead spirochetes around them (mother nature self preservation adaptation). if you think this is hogwash , read the abstract:
aac.asm.org/content/early/2015/05/20/AAC.00864-15.abstract

"Finally, we examined the ability of pulse-dosing an antibiotic to eliminate persisters. After addition of ceftriaxone, the antibiotic was washed away, surviving persisters were allowed to resuscitate, and antibiotic was added again. Four pulse-doses of ceftriaxone killed persisters, eradicating all live bacteria in the culture."

That is a serious paper. "Antimicrobial agents and chemotherapy" does not publish garbage. So if these researchers pulsed ceftriaxone and got good results, then maybe pulsing is useful. This should close the case against pulsing being something weird, voodoo or something the lymies invented...

Ok.

However please note they are pulsing ceftriaxone. This is a penicilin active against the GROWING form of lyme. What you need to add in your regimen is a penicilin active against non growing form, that is Cefdinir (see the previous research paper i shared where it showed 98% destruction against persisters). This drug is active against persisters. Persisters are bacteria already hiding, so you cannot trick them to "unhide" by using pulsing, nor you should. They are semi-dormant but some penicilins kill them. But there is no point in pulsing anything, you just need a steady rate of Cefdinir. Pulsing works with antibiotics that target growing form, not with antibiotics that target persisters.

Therefore there is no need for you to pulse Cefdinir hence you can desensitise yourself and just keep on taking Cefdinir along with the other two antibiotics, until your symptoms are gone.


Hope this is useful...

Yes, Ceftin and Omnicef are pulsed. She is seeing LL Dr J. He pulses ALL his protocols.