Pulsing abx therapy

Dear friends,

I have been searching for a thread on pulsing abx that has been discussed here some weeks/months ago. But I was not able to find it, in spite of an effort. Could you please help me to find it or re-post it? There were suggestions by Dr.J and perhaps other LLMD's, also stating which type of Abx, dosage, duration of days, breaks, period off etc, something that can be clearly and concrete followed, specifically for Lyme, not other co infections. Thank you very much, B

“ref Dr J - he starts it with i think around 6 pulses of the following - mainly targeting lyme
week 1 = doxy 400mg, ceftin 2000mg (i think) and minocycline 200mg on Mondays Wednesdays and Fridays
week 2 = doxy 400mg, ceftin 2000mg (i think) and minocycline 200mg on Mondays Wednesdays and Fridays plus tinidazole 1000mg (or metronidazole) Thursday and Friday
week 3 = no Abx

after the first pulse he adds xylitol - aiming to get to around 8-10g a day in the second week but starting with half this or less - and lactoferrin ( both for helping to break up biofilms)

self treatment is quite an undertaking - and should not be taken on lightly
he has many videos online on his youtube channel and these are well worth watching to understand his treatment approach and underlying reasoning to help you navigate treatment and supporting therapies / approaches successfully
kidney and liver function tests and CBC's as safety labs after every few rounds would be a wise precaution”

Garzie is correct that dr j pulses the abx.
But he doesn’t prescribe mino plus doxy - it’s one or the other because they are in the same “class”. He prefers mino because it gets into the brain
better.
Because of that you tend to get “head” side effects.
For me these were pressure in my head behind my eyes.
It also caused pulsatile tinnitus which was a whooshing sound in my ears - especially when my ears were on the pillow.
I also would also sway back and forth when I was standing still.
But it worked.
He also prescribes Azithromycin.

I also took dapsone and Clindamycin

Dear Garzie and Girle, thank you so much for your kind answers. May I further ask, as for dosage

- Ceftin 2000mg / day - i m only having 500mg pill, so it means one is taking it morning, lunch and evening or taking 2 times per day 1000mg? Is it supposed to create "the pulse" or the intensity of hitting of the bacteria?
I mean an example - one is taking after say 100mg mino with 500 mg Ceftin with breakfast and dinner and 1000mg Ceftin with lunch?

- Girlie has mentioned azihtromycin, how one is combining it with the above mentioned?

I assume one is getting herx corresponding to the amount of bacteria hit.
Thank you once again, best wishes,
B

Unfortunately I don’t have my Bart/Persisters schedule anymore.

But these are the meds I was taking on it:

Ceftin
Mino
Rifabutin
Dapsone
Leucovorin
Clindamycin
Pyramethamine

They were not all taken in the same week

It was a 4 week schedule

Dear friends, thank you very much! Best wishes, B

hi Bhava

in Dr J's initial protocol abx are used on the schedule 2 weeks on 1 week off - herx reactions are used more towards the end of the treatment to guide when to go on to maintenance - ie the patient may be changed to only 3days of abx per month as maintenance once herx from antibiotics pulses is negligible.

the Stratton protocol sounds similar to Dr J's initial protocol - i have no further information

as there is no agreed standard of care for chronic Lyme disease - and indeed because chronic Lyme is not really a single entity but a complex disease state - every LLMD has their own approaches - and every protocol needs to be adjusted for each individual patient.
factors such as the co-infections present, the patients other co-morbidities and the severity of herx reactions all need to be adjusted for.

unfortunately - because large scale combination antibiotic therapy trails have not been done - no one can say with confidence which protocol is best or even how well they compare to each other.
patients typically choose protocols based on which LLMD's they respect or trust the most

there are often common themes between different LLMD's approach's - typically because they are drawing from the same research or clinical experiences -
eg
-combining abx that work by separate mechanisms
-combining abx with anti-biofilm agents
-pulsing treatment

well done on using the interaction checker

i have not used Plaquenil - so have not looked into the interactions

there are however generally several levels of interactions

a few are DO NOT USE TOGETHER!
but lots of them are more USE TOGETHER WITH CAUTION
and some are JUST BE AWARE OF POSSIBLE THEORETICAL INTERACTION

obviously the first is pretty self explanatory
the others may not prohibit using the drugs together - but will give some indication of what common risk mitigations are appropriate

Dr J pulses both abx and biofilm busters
he uses xylitol and lactoferrin in the 2nd week of his 2weeks on pulse
but
Dr H uses biofilm agents continuously in his 8 weeks high dose pulsed dapsone protocol

its an interesting discussion though

Dr J believes the weeks off in his protocol are essential for the patients immune system recovery
( i think because both the abx themselves can suppress immune function - and, if you are always herxing, that in itself will put the immune system in a unnatural mode)

i have taken herbs and things like NAC and Methylene blue and bromelain continuously - all of which have some antibiofilm properties - but then pulsed abx and xylitol on top.

man did i know about the xylitol!!

Hi Girlie, I've been reading through this thread, very interesting!

I saw you mentioned about antibiotics can suppress the immune system, I haven't heard of that before but recently found out I have low neutrophils (neutropenia) and low white blood cell count. I've only had these since I've been taking the antibiotics so do you know anything about whether the antibiotics could cause this? thank you!

i mentioned that antibiotics suppress the immune system - at least while we are taking them

actually the terminology is a bit loose - suggesting the immune system is a single factor that you can turn up or down like the volume on your stereo - when in fact its a much more complex system than that.

its more like a system in which there are many "knobs and dials" that can be operated independently or nearly independently and so in fact, to continue the metaphor, anything interacting with the immune system in effect turns some dials up and some down at the same time.

however, its well documented that antibiotics can often cause neutrophils counts to drop
there may be several mechanisms for this:

many antibiotics - like tetracyclines and macrolides - and several others - are known to be directly anti-inflammatory in the sense that they chemically down regulate inflammatory signalling in the patient - this means that they counteract some of the ways the body activates the immune system - so this can in turn suppress the immune function - as inflammation is in essence an important part of the immune response.

and in the setting of an ongoing chronic infection like lyme disease - it may be that neutrophils are dying off after consuming their fair share of dead and dying bacteria that have been affected by the antibiotics, as is the function of neutrophils for instance

this second effect is linked to the longer lasting herx effects (lasting a week or more) - as studies have shown that such immune cells that have consumed damaged but still living bacteria pump out more pro-inflammatory cytokines than those that consume dead ones.
this is significant because most antibiotics are not bactericidal - and so only slow down or damage the bacteria rather than Kill them outright - and it is the immune cells that do the main work of killing and cleaning up after. in so doing we also use up these cells as they can only consume so many bacteria each before themselves dying and being recycled.

it may be these processes that Dr J is referring to when he says the off periods on the pulsing regimes are important for the recapitulation of the patients immune system.

i hope its useful

all the best