Experiences with Intravenous Abx for Neurolyme

it is known to be an active and reasonably effective treatment for Lyme

and is used by some LLMDs for the more severe cases

but as with all Lyme antibiotic treatments - a single short course of antibiotics eg 14-21 days - whether IV or oral - is rarely enough to resolve the disease and relapse after the course ends / or a few weeks or even months later is common.

this is more a feature of the biology of the disease and its many adaptations to enable persistence vs a kind of mistaken expectation that there must be an antibiotic therapy that will fix it in just a few weeks (conventional medicine doctors who are not fully familiar with Lyme will also give this expectation - but they are simply ill informed and many many papers are published in the peer reviewed literature that testify to the frequency of failures of short course antibiotics including IV) )

some simpler infections may be treatable like that - but not lyme - and so confusion or misaligned expectations often occur.

that is not to say there is anything wrong with IV Ceftriaxone as a treatment - simply that no treatment is yet known (even multiple IV antibiotics combinations at high concentrations) that can resolve lyme in most chronic patients in just a few weeks. the earlier in the illness abx are given - generally the better the response, and the longer a person has been ill the longer treatment may be expected to take.

so IV Ceftriaxone may well be a good place to start - with either further IV Ceftriaxone later based on symptoms - or transitioning to oral abx afterwards as next step for longer term treatment

the other factor to consider is that co-infections may require different antibiotics to ceftriaxone
for instance Ceftriaxone is not normally used for bartonella or babesia
so an overall treatment regime would depend on whether these or other co-infections are diagnosed or thought to be present

hi Bhava

many LLMD's combine a beta lactam antibiotic like Cefuroxime with a long acting tetracycline - like Doxycycline - as a basic protocol for lyme specifically

macrolide-tetracycline combinations are also used for lyme - but perhaps more typically for bartonella

combining them is also a valid approach for lyme

there are studies in the scientific literature attempting to compare the effectiveness of many such regimes in lyme patients but there are a large number of variables -
- individual variation in absorption of abx is highly variable
- different species and strains of lyme ( and other bacteria ) have been shown to have differing susceptibility to specific antibiotics
- the numbers in the trails are typically smaller than is needed for very good statistical meaning
so specific conclusions about which is best are rarely very dependable

however in general - using more agents - is generally thought to increase effectiveness, if each agent targets a different mechanism in the bacteria's metabolism

the mechanisms of beta-lactam and tetracycline abx are quite different and thus they are thought to be quite synergistic ( they prevent 2 different parts of the bacteria's metabolism - thereby slowing growth down more than preventing only one part of their metabolism with a single drug or two drugs acting on the same metabolic pathway )

these are only general rules as some modes of the bacteria's metabolism are not well documented - eg in persister cells of lyme - when v little metabolism is taking place and so traditional abx are having little effect
and other compounds have antimicrobial effects on persisters - but not on growing forms - and mechanisms of this are unclear

so as you can see - at the detail level there is likely a lot more going on that is yet to be unearthed - and at the top level we only have broad brush rules - "more different-acting abx is better" type stuff
but this is not always the case for the reasons stated above.

in practice it is perhaps just as effective to select well known combinations used by known LLMD's - eg Dr MR, Dr H, Dr J than to try and work it out from first principles when the science is incomplete

the other consideration is which co-infections one is dealing with - which may well give some additional weight to which abx are selected