Here's what Dr. Rawls has written on so-infections:
Situations where the addition of synthetic antibiotics may prove beneficial*
Ehrlichia, anaplasma, and rickettsia. These microbes have a higher potential to cause severe disease and less likelihood of chronic disease after treatment of the initial infection. When chronic disease does occur, it is generally characterized by long asymptomatic periods with the microbe hidden in isolated
locations in the body (months, years) followed by relapse of acute symptoms (high fever, chills, headache, muscle ache, etc.). Relapses should be treated like an initial infection with doxycycline 100 mg twice daily for 30 days or until 3 days after symptoms subside.
*
Chronic babesia infection. Babesia is characterized by relapsing high fever or positive test for babesia (see babesia blog). Sometimes triple antibiotic therapy is required to eradicate severe babesia infection. Current guidelines for babesia should be followed. Natural therapy for protozoan infections can accompany conventional therapy.
*
Persistent severe Lyme symptoms refractory to natural therapy. If chronic infection has been present long term and a person’s immune status is severely depressed, pulsed antibiotic therapy may provide benefit (though this is quite controversial). Antibiotics should never be continued for more than 30 days at a time (or symptoms resolve) and a 30 day break should be taken between episodes of antibiotics to allow the system to recover. Rotating different antibiotics may decrease bacterial resistance. Whether to use multiple antibiotics simultaneously is unknown and may disrupt the microbiome even further.
Guidelines for antibiotic use*
Doxycycline covers for borrelia and coinfections except babesia. Other antibiotics can be added at the discretion of the healthcare provider.
* Whether a single antibiotic or combination antibiotics are used,
therapy should only extend for 30 days or until symptoms resolve. Detrimental effects accumulate the longer antibiotics are used.
*
A break of at least 30 days should be taken before repeating antibiotic therapy to allow the immune system and intestinal tract to recover.
*
Probiotics including lactobacillus, bifidobacterium, and a friendly strain of yeast called Saccharomyces boulardii (inhibits C. diff.) should be taken daily (hours apart from antibiotics). Dosage: 20 – 50 billion cfu daily.
* Yeast overgrowth in the gut can be partially controlled by strictly limiting dietary sugar and starch. Ingredients in Advanced Biotic also have antifungal properties. If yeast overgrowth requires use of antifungals such as Diflucan, the drug should only be used long enough to control the problem. Long term use (6 weeks) creates drug-resistant yeast.
* Synthetic antibiotic therapy
should always be accompanied by herbal therapy. Herbs support immune function and reduce inflammation. Herbs may reduce the time period required for antibiotics to work. Herbal therapy can be continued indefinitely.
* A
gut-friendly diet should be followed while taking antibiotics; see Dr. Rawls’ Digestive Health Protocol.
*
Clindamycin, an antibiotic commonly prescribed for Lyme disease coinfections,
should never be used orally. Clindamycin is commonly associated with overgrowth of Clostridium difficile in the gut. Overgrowth of C. diff. causes severe bloody diarrhea often requiring hospitalization.
Source:
/rawlsmd.com/health-articles/when-to-consider-antibiotic-therapy