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Lyme: Oral versus IV Antibiotic Treatment

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Unread 09-21-2007, 11:20 AM   #1
Ellie
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Default Lyme: Oral versus IV Antibiotic Treatment

I've recently been having a conflict of interest with my SO. I had posted this on another website that has a fairly large Lyme Community, but hadn't gotten any feedback so I went 'hunting' online and came across some information I think everyone should know. Below I will paste my original post to state why I did this.

I am having a bit of a problem with my SO. While I am happy to see that these things come up on TV, it has casted a shadow upon how he is seeing Lyme in regards to me. I think it was the week before last while watching Diagnosis X, they had a case where a woman was treated for other things, misdiagnosed, etc. and it ended up being Lyme. Again this weekend, while watching Mystery Diagnosis a more severe case of Lyme ended up being the diagnosis (mind you, the man in question went quite some time without treatment and ended up with severe neurological complications).

My SO had seen both episodes which in turn seem to have him worried. I am currently on Amoxicillin (I couldn't tolerate Doxy, had bad reaction to it - not herx) and taking 1,500mg's per day. I don't feel better, but it's only been a week so I wasn't counting on it. Anyway, after he had seen the neurological damages caused with the man on tv, he is wanting me to call my doctors to request IV antibiotic treatment (he thinks it would be better and faster, I guess) and if they say no, he is going to ask his mom to do it who is a doctor.

I really see that his intentions are good, but I was wondering if there's any literature I could give him that shows which treatment method is best for which symptoms, stages, etc. I am unfortunately showing signs of arthritis which is my primary problem. I have an Infectious Disease Doctor, Rheumatologist and a Nurse Practitioner that I am seeing. They have suggested IV treatment only if the current treatment doesn't show any progress in around four weeks time.

[Posting the information I found in a reply]
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Unread 09-21-2007, 11:22 AM   #2
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I am quoting a few parts that stand out the most but I suggest reading the entire article that I will link at the bottom.

Quote:
The American College of Physicians and Surgeons has recently published a newsletter, "The ACP Initiative on Lyme Disease, Vol. 1, Issue 1". Which sites a recently published paper that uses serology as an end point for cure, and has a short period of a few months as a follow up. At no time were the patients symptoms assessed as the basis of successful treatment. Instead, serologies were used as the determinant (Reference: Cetriaxone (IV Rocephin), compared with doxycycline for the treatment of Lyme disease. Dattwyler RJ, Luft BJ, Kunkel MJ, Finkel MF, Wormser GP, Rush TJ, Grunwaldt, et al New England J. of Med. 3373(5):289:294 July 31 1997.) The conclusion of this paper was that a short course of doxycycline (the least expensive drug known for treating Lyme disease) is as effective as a short course of "costly" IV Rocephin.


It is quite a bone to throw to the health insurance industry by saying all Lyme patient can now be treated a short period of time with the least expensive drug, but is it true? Let's examine this article and premise: At the 1993 LDF Conference, a study was presented by Dr. Daniel Cameron, MD. In his study of more than 40 nursing home patients, he found that the relapse rate for IV Rocephin for four weeks was 25%, but the relapse rate for doxycycline was 87%. The difference in this study was that the follow up was 13 months not three months.


In a six year, ongoing study using the population of Nantucket Island, there was an interesting statistic that occurred involving the use of IV Rocephin. Since the entire population of 5000+ on the island went to only four doctors, it was easy to do long term followups on patients who were treated for Lyme disease. What was found was IV Rocephin had the highest rate of relapse, unless followed up for several moths with oral antibiotics. This was because the short duration of four weeks of treatment was inadequate to prevent relapse. This was why 57% of these patients had documentable relapses.

So, any current study that compares short-term doxycycline success with IV Rocephin is comparing two inadequate treatments to each other.

The key to the Nantucket Island study, spotting the high incidence of relapse, was in the length of the followup. The longer the followup, the higher the relapse rate. Some have said that this high relapse rate may be due to reinfection, but subsequent animal models have shown this to be otherwise.
At the 1997 LDF conference, a study was presented using naοve beagles as subjects. In this study, three groups of six beagles were studied. One group of six was infected; using infected ticks, and treated with four weeks of amoxicillin. Another group was infected and treated with a double dose of doxycycline for four weeks.

The third group was the control. In the doxycycline treated group, at three months post-treatment, it appeared that 100% were cured. But, at two years at autopsy, five of the six (5/6) beagles were shown to have active infection, or complete relapse.


A more basic study showing the inadequacy of doxycycline goes back to 1989, in an abstract from Austria. Here, the researcher incubated a live culture of Borrelia burgdorferi with doxycycline for two weeks. The culture appeared to be dead, as both motility and reproduction had ceased. The culture did not have the appearance, however, of the amoxicillin treated culture, which was filled with Lysed cells. So, using micropore filters, the researcher filtered doxycycline treated cultures, and separated the intact Borrelia from the supernatant. He then washed them, and placed the filtrate back into fresh culture media. Over two thirds of the cultures reactivated, becoming motile and beginning to reproduce. It appeared that doxycycline immobilized the bacteria by interrupting protein syntheses and metabolism. This pushed the cells into a non-metabolic state. Since the doubling rate is often used as a means of determining if the cells are alive, it was assumed that the cultures were dead, when they were in fact just dormant.
Link: http://www.canlyme.com/tom.html
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Unread 09-22-2007, 05:29 AM   #3
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Red face I am sorry Ellie...

I am not a Lyme specialist.

But I can offer some general information about the actions of some drugs.

Doxycycline is part of the tetracycline family. It is a bacteriostatic agent.
That means it stops bacteria from growing/mulitiplying. It does not kill. It is still useful however in many diseases.

Cephalosporins and penicillins are examples of bactericidal agents. They kill outright.

So the article above is correct in some statements. What I do not have is the skill to comment on is how that impacts Lyme. In general bacteriostatic agents rely on the body for removing the intruder by the immune system.

I do not know if once Lyme is entrenched in tissues what antibiotics should be used. Certain ones do not penetrate well into some areas. Others do.
Cephalosporins like Rocephin are typically used for tissue infections following surgery/trauma. But they do not penetrate fluids well such as sinuses or middle ear fluid.

The value of doxy in general in medicine is its broad spectrum of action against many things, including anthrax. So I know it is a proven drug for many things. I just don't know where now in the Lyme community it stands.

Alot of changes have occurred in Lyme treatment, over the years. So I would have to defer to your infectious disease specialist on this question.

Antibiotic therapy that continues can deplete nutrients and cause side effects. Doxy is a huge depletor of many things. If you want I'll look that up for you. Rocephin (Cefatriaxone) depletes about the same things..so there is not much difference there.
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Unread 09-24-2007, 01:48 PM   #4
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Quote:
Antibiotic therapy that continues can deplete nutrients and cause side effects. Doxy is a huge depletor of many things. If you want I'll look that up for you. Rocephin (Cefatriaxone) depletes about the same things..so there is not much difference there.
Sorry it took me so long to reply!

I'd really appreciate it if you'd do that, as long as it doesn't require you going out of your way or spending too much time on it.

Thanks bunches for the information, it helps a lot.
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Unread 09-24-2007, 01:53 PM   #5
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Here are two things that my be helpful.

I recommend reading Dr. Joseph Burrascano's 2005 Diagnostic Hints and Treatment Guidelines For Lyme and Other Tick Borne Illnesses (on-line). He is one of the top Lyme doctors in the country, and many Lyme doctors follow his protocols. I also recommend the book "Everything You Need To Know about Lyme Disease
(2nd edition)" by Karen Vanderhoof-Forschner.

I happened on this site for a whole different reason. I belong to a chat room with a large Lyme group. So of the people are super knowledgable.



Take care

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Unread 09-24-2007, 02:41 PM   #6
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Yeah, I've read both. I have tried (to the best of my ability) to gather as much information as I can without following any 'hype' (as a lot of things these days seem to carry).

My main goal is to find the best, safest and most effective treatment for myself. Before I dive in too deep, I want to know everything about anything they want to do to me or want me to take, which is primarily why I'm trying to find the best factual information that is available to me as well as check out some of the studies regarding Lyme and the treatment of.

I've gone through the labrat phase with my epilepsy and I am certainly not willing to subject myself (or my vital organs) to such things again.
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Unread 09-24-2007, 04:47 PM   #7
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Lightbulb here are the depletion lists:

Doxycycline:

lactobacillus acidophilus
bifidobacteria bifidum both of these from killing in bowel by doxy

biotin
inositol

Calcium
Iron any supplements of these need spacing away from doses of doxy
magnesium

Vit B1
B2
B3
B6
B12

Vitamin K due to killing beneficial bacteria in the bowel by doxy.

Rocephin
Lactobacillus
Bifiobacteria
Biotin
Inositol

Vitamins B1
B2
B3
B6
B12
Vitamin K

Lyme treatments that are long (months as opposed to days) end up depleting the patient, and leading to side effects.
Candida overgrowth
loss of beneficial bowel bacteria
So a quality Probiotic should be considered, and/or a quality active culture yogurt daily.

I think attention to these nutrients will make the treatment less harsh, and prevent noscomial infection of the bowel by Candida yeast and C.difficle.
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Unread 09-24-2007, 05:27 PM   #8
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Is Amoxicillin better? I am taking 1,500mg per day right now. I have a follow-up on Friday to discuss increasing or changing my antibiotics.
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Unread 09-24-2007, 05:49 PM   #9
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Post amoxicillin...

has the same depletion list as Rocephin.

What needs to be considered, it the effect on the Lyme. You can always make
up the depletions. The actual effect on the organism I think, is the deciding
factor.
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Unread 01-02-2008, 12:19 PM   #10
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Default orals versus IV

orals are great if you are realteivly new and not neuro-

if you are neuro you need IV or IM-

I needed 9 months of IV Rocephin- the first 6 I had no big changes at all!!!
One year of orals did NOTHING- I just got worse & worse!!!

Make sure to get treated for coinfections because they are the rule not the exception. In our 350 person support group from the last 8 years mayb 5 people have JUST had Lyme- the rest have all had mixed infections-

Babesiosis- Ehrlichiosis- which require different drugs- so you need a good LLMD!!!
Sincerely,
Sarah
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