I cannot really comment on the best treatment. It depends on how ill you are from it and what other factors play a role. Some people get rid of it on their own.
Dr. Mozayeni seems to be having results with Clarithromycine + Rifampin and later switches from Rifampin to Rifabutin. He uses large doses with his patients and this seems to get most of them better.
Besides an antibiotic combination he also uses complementary supplements and medicines to restore the adrenals, thyroid and work on improving the bloodflow with serrapeptase and nattokinase.
Dr. Horowitz uses Doxycycline, Rifampin and Dapsone as his persister-protocol. He is getting the difficult patients better on this combination. He sometimes uses PZA instead of Dapsone for Bartonella. I think he uses 200mg 2x daily doses of Doxycycline or Minocycline in 100mg 2x daily but I am not sure.
!!! These are general antibiotic combinations. Not personal medical advice. !!!
What treatment needs to achieveBesides the right dosage to get excellent concentrations in the central nervous system, you need a long enough treatment. Most antibiotics only prevent the growth of the Bartonella and don't actually kill it. Only Gentamycin is bactericidal and is quite toxic.
Because you need a long treatment length the best options are antibiotics that are tolerated well and are generally used long-term for other infections.
Orals: - Clarithromycine (or Azithromycine, but Clarithromycine works slightly different) can be rough on the gut
- Doxycycline (higher dosage) , Minocycline, very safe unless you have an allergy or benign intracranial hypertension
- Bactrim (or Trimethoprim when you have a sulfamethoxazol allergy) When tolerated very safe for longterm use. Lots of elderly people with vasculitis are on it for the rest of their lives.
- Rifampin/Rifabutin (when your liver enzymes rise too much on Rifampin, Rifabutin might be better tolerated, you have increased risk with flu syndrome/allergic reaction when using Rifabutin)
- Fluoroquinolones (Ciprofloxacin/Levaquin) Not first choice, probably last choice because of neurotoxicity and tendon problems. Is used longterm in some osteomyelitis infections, some forms of Tuberculosis, Q-fever in some cases...
IV:- Gentamycin 10 days IV could be used at the start of very stubborn or chronic Bartonella infections. Only in the severely ill.
- Ceftriaxon (not really effective but can penetrate nervous system very well and kill off extracellular Bartonella quite effectively) Best used as pulse-therapy next to two oral antibiotics. Also, in severely ill who also have a Lyme infection.
Most orals are also available as IV when there is a lot of GI upset.
Persister-drugs:Clofazimine, Pyrazinamide, Dapsone, Artemisinin?, Oregano Oil?
So think about
combining 2 orals. Rifampin and Doxy, Rifampin and Claritho, Rifampin and Bactrim... etc.
Or something in that fashion. When there is Lyme this needs to be covered too. In the laboratory Trimethoprim also acts on the Lyme spirochete form. Gasser used it in his treatment in the early days and had good results from it in patients.
When needed you can add a persister-drug. You can pulse a persister-drug.
My treatmenthigh dose doxycycline 300mg (can be raised to 400mg) , trimethoprim 200mg 2x daily (can be raised to 400mg 2x daily) rifabutin 300mg daily, plaquenil 200mg daily.
For biofilms: nattokinase and serrapeptase. 1 capsule 2x daily.
For the liver: s-acetyl-l-glutathione 100mg 2x daily, milk thistle extract 500mg, nac 600mg
Methylation: methylB12, methyl-folate
Vitamin D because I become deficient without supplementation. Zinc because I become deficient without supplementation.
There can also be biofilm developing on the lining of blood vessels. This can cause symptoms because it stagnates blood flow. Serrapeptase and nattokinase are not enough to break up all biofilm.
Dapsone is great at dissolving biofilm in combination with rifampin and minocycline. Clofazimine might work too. Rifampin does penetrate biofilm the best of all antibiotic options but does not dissolve the biofilm.
Maybe artemisinin does that. Oregano oil is doing this in the laboratory but I don't know if it acts systemically.
!!! Artemisinin can cause neurotoxicity in animals in high dosages. Also, I'm not sure if you can combine these herbal-derivatives with Rifampin or other liver taxing drugs for example. They might cause liver problems in combination with other drugs that need a lot of processing by the liver. !!!
Post Edited (LymeBasics) : 10/14/2017 4:32:05 PM (GMT-6)