Lyme Treatments : NB this is meant for informational purposes only & is not designed to replace advice from a doctor..
Treatments vary depending on the stage of the disease, any co-infections that may be present & also whether you are allergic to penicillin. Most people start with a drug called Doxycycline. It is considered vital to get a high blood volume of the medication to adequately conquer the disease. Therefore 400mg per day orally (200mg twice per day) is considered sufficient. Some people who are severe can be given Ceftriaxone by IV, or IM (intra-muscular) injections although there’s no guarantees of being able to obtain this in Ireland. Other medication used for treatment of Lyme is Amoxicillin & Tinidazole – each type of medication can target the different forms of borrelia (the bacteria causing Lyme). These 3 forms are spirochete, L form & cyst form. Sometimes a combination of drugs have to be given to eradicate all 3 forms. (Latest studies by Eva Sapi highlight the different drugs helpful for each form).
For more information on treatments, as well as supplements & dietary advice check out the guide written by Dr Burrascano (a very well respected doctor renowned in the field of Lyme).
An EXCELLENT slide show by Jospeh Burrsacano
A useful chart showing the antibiotics most commonly used for Lyme & its various co-infections is available at:
O – Oral
IV – Intravenous
IM – Intramuscular
This is the best guide I’ve come across from the UK on ‘effectively’ treating Lyme!
# The early use of antibiotics (for example doxycycline) can prevent persistent, recurrent, and refractory Lyme disease. Antibiotics shorten clinical course and progression. The duration of therapy should be guided by clinical response, rather than by an arbitrary treatment course. Long courses of antibiotics may be required (2-4 weeks or longer).
# Jarisch-Herxheimer reaction may occur soon after treatment is initiated.
# First-line drug therapies for Lyme disease include oral doxycycline (and tetracycline), amoxicillin, azithromycin, cefuroxime, and clarithromycin. These antibiotics have similar favourable results in studies. For many Lyme disease patients, there is no clear advantage of parenteral therapy.
# Intravenous antibiotics are used in severe cases (for example encephalitis, meningitis, optic neuritis, joint effusions, and heart block); or where there is failure of oral medications – in patients with persistent, recurrent, or refractory Lyme disease. Ceftriaxone, cefotaxime, and penicillin are commonly used intravenous antibiotics. The precise regime will depend on the individual situation but high doses of antibiotics, combination of antibiotics, sequential regimes and prolonged duration (one month or longer) are advocated.
# Surgical synovectomy should be reserved for knee pain failing antibiotic treatment. Intra-articular steroid injection may be useful for persistent knee pain but runs the risk of masking persistent infection.
# Treatment of Lyme arthritis – Cefotaxime, ceftriaxone, doxycycline and amoxicillin plus probenecid are all effective.
# Treatment of late neurological Lyme disease – Cefotaxime has been shown to improve neuropathy in patients with late Lyme disease. Intravenous ceftriaxone has been shown to be effective in Lyme encephalopathy. Other studies have shown no benefit of antibiotic for late neurological Lyme disease.
# Temporary pacemaker may be required where there is carditis and conduction defects.
An article regarding Rheumatic disease and mycoplasmas:
Successful treatment of rheumatic diseases with antibiotic (tetracycline, etc.) therapy is more than prescribing a standard dose of antibiotic to every patient and then expecting somewhat uniform results. This is true of treating anything else as well. But antibiotic therapy necessitates treatment and prescribing from a conceptual view of the disease mechanism in order to be able to properly titer the dose and deal with individual expressions and differences in patients’ diseases.
A Conceptual View
The concept is based on the premise that no major disease was ever understood or conquered until its cause had been identified. A great deal of published literature supports the fact that mycoplasma and bacterial L-forms are now recognized as being widely distributed throughout nature, as having a precise affinity for joint tissue and are known to produce arthritis in a variety of species including rats and mice, cattle, swine, gorillas and elephants. As one ascends the phylogenic scale, tissue hypersensitivity or reactivity becomes an extremely important part of the defense mechanism against infection. Both mycoplasmas and L-forms promote a high degree of tissue hypersensitivity in a manner comparable to the tubercle bacillus, the brucella organism and the beta-hemolytic streptococcus.
* Focus on an antigen trigger.
* Pursue treatment long enough to eventually suppress antigen formation, Improvement may not be seen quickly. It is frequently 6 months to 1 year before there is evidence of significant improvement.
* Give antimicrobial medication in conjunction with antiinflammatory medication in order to reach beyond the inflammatory barrier to the source of antigen production.
* Tetracyclines by themselves are sometimes ineffective without preparing the way for their modes of action. NSAIDs reduce the inflammatory barrier without depressing the immune system. Probiotics may be used to protect the GI tract.
Benefit vs Risk
* Tetracyclines are not accumulative (as is gold – a single shot of gold stays in the system at least a year) & anti-malarials. If delayed sensitivity to the drug develops, it is easily countered by stopping the antibiotic for a short time (a week) without losing the benefits already gained.
* Tetracyclines affect the soma of the microbe rather than the cell-wall, thus drug resistance is rarely a problem. Their sensitizing effect, as judged by their long-term use in the treatment of acne and broncheostasis, is [generally] nil.
* Initiation of all antimycoplasma medications such as tetracycline (as well as gold salts, Plaquenil or chloroquine) can produce a flare reaction: the Herxheimer reaction. This reaction is [often] treatable by reduction in dose of the antibiotic.
* Once reduction of mycoplasma antigen (remission) is established, it can be maintained indefinitely except for occasional non-damaging flares associated with seasonal changes, stress, infection, trauma or other environmental factors which allow a resurgence of antigen.
[Some]other drugs that have proven effective with this treatment are: clindamycin, lincomycin, azithromax, cefuroxime and erythromycin.
Knowledge of the entire spectrum of pharmacodynamic effects of an antimicrobial is an important prerequisite to understanding how it can be optimally administered to patients.
Late & Chronic Lyme by Sam Donta MD
Per the European CDC website: NB: details have changed since publication of the text posted below…
The clinical presentation of LB ranges from asymptomatic infection to serious chronic illness, usually affecting the skin, nervous and musculoskeletal systems, and rarely, the heart. Three main stages of the disease in humans can be distinguished. The incubation period can vary between a few days after the tick bites (stage I) to months or even years for stages II and III of the disease.
* Stage I (starting days or weeks after the tick bite). Characterised by erythema migrans in circa 60-80% of cases (a red rash or patch on the skin about 10 cm across that may expand peripherally as a palpable band, and may or may not be itchy); other early symptoms of LB include flu-like symptoms, low fever, fatigue, headaches and muscle or joint pain. This may or may not be followed by stages II and III.
* Stage II (weeks or months after the tick bite). This stage may or may not be preceded by stage I (50% of cases): neuroborreliosis occurs in approximately 20% of symptomatic LB-infected individuals, and often takes the form of meningoradiculitis, meningitis or meningoencephalitis; other symptoms in this stage include multiple erythemata, Lyme arthritis, borrelia-lymphocytoma or carditis;
* Stage III (months or even years after the tick bite). Chronic Lyme arthritis, lymphocytoma, acrodermatitis chronica atrophicans, encephalomyelitis or chronic neuroborreliosis.
Although the diagnosis of LB is primarily based on clinical signs, such as erythema migrans, clinical findings alone are not sufficient for diagnosis of non-cutaneous manifestations of the infection; laboratory confirmation is needed.
A wide range of laboratory techniques have been developed for the direct detection of B. burgdorferi s.l. from clinical specimens, including microscopy assays, detection of B. burgdorferi-specific protein or nucleic acids and, most commonly, bacteriological culture from various tissues – but these have their limitations.
More promising methods include PCR-based molecular techniques that can rapidly confirm clinical diagnosis of LB, and identify Borrelia genospecies in clinical specimens or cultured isolates. However, molecular methods are also controversial since different assay protocols, gene targets, and limited clinical validations are employed in different laboratories.
Management and treatment
Treatment of the vast majority of LB cases is based on antibiotics, with drug type, dose, route (oral or intravenous) and duration varying with the stage of the disease, as well as symptoms. Most authors agree that all symptomatic LB cases should be treated in order to avoid progression to later stages of the disease, and it is well accepted that the earlier treatment begins, the less likely it is that more severe forms will follow
Drug interactions checker
Look up supplements, herbs & vitamins, over the counter meds as well as prescription meds to check for any interactions:
TOUCHED BY LYME: Lyme patients need treatment options
15 June, 2010
The Institute of Medicine, part of the National Academy of Sciences, is in the midst of taking a look at Lyme disease. In April, the IOM heard from various scientists. Today, the IOM committee held the second of several “listening sessions” via telephone conference call, which allowed Lyme patients and advocates to offer their opinions as well. Here’s what I told the committee.
(Remarks delivered by phone conference to the Institute of Medicine on June 15, 2010. Note: there was a 3-minute limit on public comments.)
Five years ago, my then-13-year-old daughter became seriously sick and disabled. First she needed crutches…then a wheelchair…then became completely bedridden. Yet the top medical experts we consulted couldn’t put a finger on what was wrong, and offered no effective treatment.
We wondered about Lyme disease. But the specialists refused to even consider Lyme in the differential diagnosis. Why? The answer was always some form of “Because it couldn’t possibly be Lyme disease. Period.” I later learned this viewpoint was based on the very narrow definition of Lyme put forth by the IDSA guidelines. Also, Lyme has become a political hot potato, and many doctors choose not to engage with it at all.
As our daughter’s health continued to deteriorate, we finally stepped outside of the medical mainstream…and she was diagnosed and successfully treated for Lyme and two other tick-borne infections. After more than three years in a wheelchair, too sick for school or anything else, she got her life back. Now she’s walking, driving, and last week proudly graduated from high school.
As a Lyme disease support group leader, I hear similar stories all the time. Patients with many of the symptoms of Lyme disease are told by their doctors:
* there’s no Lyme in this county
* the tick wasn’t attached long enough
* that bull’s-eye rash is actually ringworm
* that positive ELISA test was really a “false positive”
* your symptoms are merely “the aches and pains of daily living.”
Yet, many of these people—like my daughter—are ultimately helped by long-term Lyme treatment.
The scenario for people with breast cancer, or leukemia, or heart disease, is very different. Those diagnoses come with treatment options. Patients choose which treatment they prefer—more aggressive, less aggressive, watchful waiting. Lyme patients do not get treatment options.
Why should Lyme patients be systematically denied access to medical care that could vastly improve their quality of life? Especially when the only alternative is to continue to drown in pain and misery?
The recent IDSA Lyme review panel chose to ignore hours of testimony and hundreds of pages of documentation that showed that Borrelia can be a persistent infection, and that many people are helped by long-term treatment. Yes, the science of Lyme is still unsettled. There is still much to learn. But why deny people the chance for a better life in the meantime?
You can contact this blogger at firstname.lastname@example.org.
Antibiotic Patch may help prevent Lyme
“Our approach simply involves applying a transparent, self-adhesive plaster to the site of the wound,” says Straubinger. “Because the plaster contains very little antibiotic, the effects are localized and side-effects are negligible.”
A look at meds used for Lyme & co-infections plus tips on their uses
Treatment becomes complicated when there are coinfections, that is, if you have Lyme and another one or more of the other bacteria and protozoa such as Babesia or Ehrlichia. Often treatment of Lyme is more successful when coinfections are first eliminated.