Can bartonella become resistant to rifabutin like it does rifampin?

LJohn23 said...
Also, I see that people add plaquenil, allinia, to there combo for bart. Is the reason just additional killing or? In gonna be putting myself on antibiotics soon and still tied between rifabutin and mine or rif and biaxin.

I don’t think bart becomes resistent to Rifampin or Rifabutin if you take it with at least one - preferably two abx.
Can’t answer your question about Plaquenil because neither of my LL drs prescribes it. I read something about Plaquenil making the other antibiotics work better.
I don’t like it’s really long half life.

LJohn23 said...
Your taking mino and rifampin right? Do you think its a good combinaction and what abxs do you think you could add?

Well one week I take Rifbutin plus Ceftin and the persister drugs dapsone and daraprim.

Another week I take Clindamycin and mino with rifabutin

I have been on rifampin, bactrim and clarithromycin for a few months (gor bart) and I finally feel like I've had a break in my herxing. I hope it's not going to developer resistance because I am finally having days without heart and breathing problems.

LJohn23 said...
Are the persisters only for Lyme or also bartonella?

I think when they say persisters - it’s referring to lyme.

I think it can? At least my LLMD is under that assumption too. Most of her patients she sees plateau on rifampin + biaxin after a certain interval of gradual improvement. Then she switches in rifabutin for rifampin. Supposedly rifampin brings down the levels of all other abx whereas rifabutin increases the levels and thus provides the extra oomph to kill off the rest of the pathogen load?

I am scheduled to discontinue my rifampin in about a week to start on rifabutin as I've been feeling better but not fully.

My LLMD told me to take Rifampin 30min before the other ABX on a empty stomach.
She never mentionned that it can decrease other ABX effectiveness buuuuut...
She did mention that when you stop Rifampin, there's a chance it never works again for you because of resistance. Hence the reason why she want good bloodwork numbers before starting Rifampin: the idea is to not stop it unless absolutly necessery.

I did see a plateau with Rifampin, Azithromycin and Plaquenil. My body totally crashed, and it felt like they weren't working anymore. I took a break from those two, and later when I went back to rifampin, I had a great response. Started feeling better instead of worse. I don't technically know the answer to your question, but just sharing what happened to me.

Girlie said...

xpeetzax said...
I think it can? At least my LLMD is under that assumption too. Most of her patients she sees plateau on rifampin + biaxin after a certain interval of gradual improvement. Then she switches in rifabutin for rifampin. Supposedly rifampin brings down the levels of all other abx whereas rifabutin increases the levels and thus provides the extra oomph to kill off the rest of the pathogen load?

I am scheduled to discontinue my rifampin in about a week to start on rifabutin as I've been feeling better but not fully.

Interaction between Rifampin and Biaxin BUT not with minocycline.

Same with the rifabutin

Yup you are right Girlie. Mentioned Mino to my LLMD, she thinks its an excellent drug too...just wants to first see if my current regimen is effective enough then will try mino if I plateau again.

LJohn23 said...
Xpeetzax- im pretty much going to be self treating with abxs because I can't afford a llmd sadly. Do you know of a decent abx I could add if I decide the rifabutin and mino? Would Azithromycin be a good addition? Also, what dosage are you at for the biofilm enzymes?

You didn’t ask me... but... Omnicef or Ceftin goes with Rifabutin and mino.

LJohn23 said...
Girlie- what is the purpose of adding those on?

Omnicef is better but we can’t get it on Canada - so the alternate is Ceftin.

Im not sure why but it’s one that Dr J prescribes.

He likes to do a trio.

Bactrim is another one - but I had a skin reaction to it so didn’t want to continue on it.

LJohn23 said...
So, from what I know, the main bart drug is rifampin/rifabutin. Although it takes a while , it is effective? Does it starve the bacteria? And, since the bart can become resistant, two antibiotics can be prescribed next to it so that won't happen?

Well, there is a more effective drug (apparently) class- the fluoroquinolones (ciprofloxacin and levaquin) that hit bart good...but they come with black box warning labels (more than one) so many of us don't want to take those.

Rifabutin...is next (from what I've heard) and then Rifampin.

Bactrim can sometimes treat bart effectively - but from what I've seen...its usually cases that aren't as chronic..ie only a few months - not years.

Some LL Dr.'s just prescribe on antibiotic with the Rifabutin/Rifampin.
Dr. J prescribes two.

I don't know exactly how the drugs work. (I know some stop the bacteria from replicating...)

** Do you have a LLMD to discuss this with? **

I just re-read - and you aren't with a LLMD...right? What about a 'regular' Dr.? Do you have someone to give you safety labs to keep an eye on liver/kidney function,....etc.

I would recommend bi-weekly to start off TSH, CBC, CMP. Rifabutin and Rifampin, can potentially affect your platelets, WBC, neutrophils, and thyroid. then if stable, go monthly on testing.