Tetracycline/Diflucan Protocol

Any updates on how well this protocol may work for Bartonella? Is it well-tolerated? Could you substitute Mino for the Tetra?

I believe SP's protocol was two weeks on/two weeks off. Thanks.

i am very interested in this also

fluconazole is in there i think because there are in-vitro studies of this group of azole anti-fungals that Zhang et al did - where they found several of them to have higher activity than standard bart drugs (note that there are many azole type drugs - but not all are in this family that were shown to have high activity )

there is also one small study out of Europe that showed 25 days straight of fluconazole alone cured the majority of chronic lyme patients - hinting that it is either effective for a co-infection that was holding patients back - or that it is having some other as yet unknown but very interesting immune mediated effect - (i do not believe fluconazole has been found to have any direct anti-borrelia activity in vitro)

i did some reading around its immune related effects and found references to fluconazole "rescuing the neutrophil suppressing effects that normally occur with antibiotics" so it could be that this is how it is somehow enhancing recovery

Dr SP seems to be the only prominent LLMD who prefers tetracycline to doxycycline for lyme and bart. his reasoning isn't fully clear to me - mostly empirical experience based i think. says it does not apply to all patients - but to the majority - he find tetracycline works better. he says the standard dose is around 7x higher of tetra - but presumably it was set that way based on studies that found that was the dose needed to be effective - in a similar way to doxy - so not sure how that plays into his reasoning.

its known there are large variations in abx blood concentrations after oral ingestion - which can vary from person to person 10x or more ( ref Burrascano) which goes some way towards explaining the hit and miss efficacy of every regime in individual patients.

other tetracycline class abx may work just as well in this combination ( doxy, mino etc )- dependent as much on the person as the drug.

if you try this please do report back with how you get on.

note - liver safety labs are needed for fluconazole

Thanks for the input. Not sure if we'll use it yet (it's for a family member) but will plan to update if so. I myself have just started adding some Diflucan to my protocol. Have only taken a couple so far but plan to continue pulsed as able depending on herxing. When I took it, I noticed a flare in some of my symptoms not long after taking, but it wasn't like real severe. The herx from the Diflucan seemed to be similar to a typical Lyme/Bart herx for me. I have only taken two so far.

I guess there's always the possibility it was targeting yeast in biofilms.

tickbite - thanks - looks like he published some of his findings back then lso

outcomes didn't look bad for monotherapy

I am guessing its this that Dr SP is using it on the back of - as he is very much into the literature for his treatment protocols and favours safe older drugs over newer more experimental ones

[url]https://academic.oup.com/cid/article/25/Supplement_1/S52/523864[url]

I used this protocol - the main reason was not being able to tolerate Rifampin any longer. I don’t see why you couldn’t experiment and substitute Mino for tetra for better BBB penetration but SP has found success with it and Dr K will use it in patients who don’t tolerate Rifampin. I think tetra is supposed to be 3 times per day but I did it twice per day. You should get liver enzymes checked during the 2 week break just to be sure. Diflucan is one of the easiest drugs I’ve ever tolerated (it’s been a while though). First dose I felt warm (presumably from it killing all the yeast/candida in my system m) and never felt anything after.

So is it reasonable to try Tetracycline even if you are allergic to Penicillin?

I read this:
"Various studies have noted patients with a penicillin allergy also exhibiting an allergic response to tetracycline [26,29,30]. Some researchers have wonder if a penicillin allergy may predict tetracycline sensitivity. If such a relationship between penicillin and tetracycline allergy were to exist, this would be clinically significant, since tetracyclines are often chosen as an alternative therapy for infections in patients with penicillin allergy. However, an immunologic study of one such patient that utilized direct skin testing, passive transfer analysis, and hemagglutination testing determined two different and unrelated antibody-mediated responses for penicillin and tetracycline sensitivities, respectively [29]. These data contradict the presence of a direct relationship between penicillin and tetracycline allergy."
https://www.ncbi.nlm.nih.gov/pmc/articles/pmc6789857/

Would like to know if there are cases on this forum where people allergic to Penicillin took Tetracycline and did fine. Thanks.