Lyme persister abx protocols?

I have never tried any of the lyme persister protocols as i am mostly dealing with bartonella.

Dapsone + doxy + rifampin is the Dr H special as you know. I think he is using double dose dapsone with it and even using DSF in lower doses in combination with it.

I personally think dapsone + mino + rifabutin would be a stronger combo. Mino gets into brain better. Rifabutin has stronger in vitro effects against lyme persisters than rifampin and it has less of a drug lowering impact on the otther antibiotics than rifampin.

Flagyl and tindamx are also used against lyme persisters (tindamax gets into brain way better)

Pyrazidamide is another strong persister drug dr h has experimented with.

Allicin garlic extract (allimed product) might also hit persister lyme - garlic oil at least does in vitro - and i think it passes into brain

Obvi I am no doctor, but If I was you, and intent on wiping this thing out, and not prone to severe herxing - I would use the Dr H dapsone or double dapsone protocol (potentially with my mino rifabutin modifications) combined with a low/moderate dose of DSF, like 200-250 mg.

i don't think there is such a thing as the single best protocol for lyme persisters for a number of reasons

-there is pretty good evidence that what we call lyme disease is in fact a polymicrobial infection - each of these microbes have different susceptibilities to different antibiotics

-similarly different strains of the same bug have been shown to have quite different antimicrobial sensitivities - up to around 10x i think

-there is also good evidence that the blood and tissue levels of antibiotics achieved in different individuals varies dramatically - sometimes up to 100x - so an antibiotic may be active for one of the bugs in question but just not reach useful concentrations in one person - but be a miracle sure for another

- the "host response phenomenon" is known to drive symptoms pictures more than the actual microbes - so one person might have rampant CNS inflammation - while another has debilitating fatigue - from the same microbe/microbes - and each may respond differently to the same antibiotic

given the above are pretty well demonstrated in multiple studies - i think the LLMD's are just doing what human beings do and trying to fit their working theories to the facts as they see them - and this is the reason for the myriad of different approaches and theories that abound.

overall those that take a broader view than just load the patient up with multiple antibiotics seem to be the ones that work best - i.e. the other factors that help support the patients own immune system( antibiotics never work alone in live patients) may actually be more important that the exact abx combination

Rosi said...
Girlie,

I see the same doctor as you. I asked him a while ago about persisters and specifically about dapsone. He said we treated you for persisters. Of the meds you mention above I only have been on Daraprim, Rifabutin, minocycline and tinidazole. The last 3 were in my maintenance protocol for years. I have been with him since 2011 and we still cant find the solution to my cognitive issues. sometimes he drives me nuts....

Oh sorry - I forgot you were seeing Dr J.