Need some help/advice about how to handle doctor and medications - LymePickle or Chapelle, maybe?

What dosage are you on of Zithromax?

The best thing you can due is keep researching and trusting your gut. If you really feel that strongly about dropping the zithro - I believe your doctor might at least let you try, and if you start backsliding maybe you weren't ready to drop it or lower the dose.

If you are taking a lot of antioxidants like vitamin C, Green tea (ECGC), cats claw (there are many more) that can prevent a lot of the damage you are concerned about as far as prolonged antibiotic use.

Have you talked with the LLMD about a timeline? Mine refused to, but I was in/out relatively fast with treatment. Maybe if you have a set idea of how long they plan to keep you on this, it will make sense and if it doesn't and it sounds too long, maybe you can look up other options.

~beth

I guess that's another thing... I am getting better, actually I'm doing quite well, so hard to argue with her when I'm showing so much progress.

It is hard to imagine going back from where I came.

Truthfully there isn't a whole lot of data on it that I can see for higher doses with extended use.

http://www.rxlist.com/zithromax-drug/indications-dosage.htm

That website (though not a favorite source) states that often 1 gram or 1,000 mg are often administered at one dose/day but again, they are speaking of short term use. There was this on there in regards to 'chronic therapy.' Also, looking at the peak levels- azithro really isn't any different then other drugs. peak levels are 10-14 hours after administration. The difference between it and other drugs is that it does stay in certain parts of your body longer then others, ie you will still urinate drug a few days after administration but it will be very dilute if that makes sense?


hronic therapy with 600 mg daily regimen combined with ethambutol

The nature of adverse reactions seen with the 600 mg daily dosing regimen for the treatment of Mycobacterium avium complex infection in severely immunocompromised HIV-infected patients were similar to those seen with short term dosing regimens. Five percent of patients experienced reversible hearing impairment in the pivotal clinical trial for the treatment of disseminated MAC in patients with AIDS. Hearing impairment has been reported with macrolide antibiotics, especially at higher doses. Other treatment-related adverse reactions occurring in > 5% of subjects and seen at any time during a median of 87.5 days of therapy include: abdominal pain (14%), nausea (14%), vomiting (13%), diarrhea (12%), flatulence (5%), headache (5%), and abnormal vision (5%). Discontinuations from treatment due to laboratory abnormalities or adverse reactions considered related to study drug occurred in 8 of 88 (9.1%) of subjects.

That study was based on continual use for 90 days at 600 mgs/day in immunocompromised patients. Adverse rxns were similiar to those on short term medication. I can't really give you a direction but if you think you have been on it long enough - you don't have to push too hard, you can just tell the llmd that your body told you its time to stop that medication and smile. :) It will be A-Okay!

Wow, thank you opugirl! That's awesome. I'm honestly on the fence with this. What would you do personally? Not enough research out there for the huge dose I'm on, pretty risky?

Girlie, Zithromax 600 mg x2/day is the only one abx I've been on for 12 weeks, just added ceftin 500 mg x2/day yesterday. Haven't started taking it yet. I have a 3.5 hour flight tomorrow w/ with a 20 month old, NO herxing tomorrow for me!!! I'll start it Friday or Saturday.

Dr. Burrascano's treatment guidelines state for adults 500-1000 mg of zithro daily.
This was the 2008 edition, but can't find a newer edition.

That's good you're doing so well on it!
1000mg per day isn't too far off from what you're taking.

Good for you being cautious, though.

http://aac.asm.org/content/57/4/1736.full

Here is an article on azithromycin in various tissues.  I read articles like this before but all I did was google azithromycin concentrations in tissues.  I really like how it accumulates in white blood cells and this in turn delivers the drug effectively to areas of the body with infection.  Azithromycin is actually the drug that revolutionized Chlamydia treatment, the Doctor says take 5 pills all at once and you are cured!  Reason being is it is azithromycin and it accumulates in tissues and stays there for a long time.   

If you want the better antibiotic between Azithromycin and Clarithromycin.  (Zithromax or Biaxin), Biaxin is actually more effective for specifically Borrelia.  Zithromax is the better drug to use if there is borrelia and a co-infection or a few co-infections.  Also Biaxin passes through the blood brain barrier whereas Zithromax does not. 

I believe that my bartonella is now finished treatment.  So if my current regimen fails, I am going to ask for a combo of Biaxin and Plaquenil. 

 

Thank you Pickle and Chapelle! I appreciate your expertise, and the article. Thanks for calming my anxieties a bit Chapelle.

I'm going to discuss this with her, but I will probably leave things the way they are for the next 3 weeks until I can see her face to face again.