CONTROVERSY CONTINUES TO FUEL THE "LYME WAR" By Virginia Savely, RN, FNP-C
- article at link.
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This article is informative concerning any lyme and involvement with neurological function and she gives a time line for cystic form, etc. in this article.
Keelber, I'd say that covered a good share of what she's asking.
quote: COMBINATION THERAPY Treatment of chronic Lyme usually requires combinations of antibiotics. There are four reasons for this:
1. TWO COMPARTMENTS- Bb can be found in both the fluid and the tissue compartments, yet no single antibiotic currently used to treat Bb infections will be effective in both compartments. This is one reason for the need to use combination therapy in the more ill patient. A logical combination might use, for example, azithromycin plus a penicillin.
2. INTRACELLULAR NICHE- Another reason, discussed below, is the fact that Bb can penetrate and remain viable within cells and evade the effects of extracellular agents. Typical combinations include an extracellular antibiotic, plus an intracellular agent such as an erythromycin derivative or metronidazole. Note that some experts discourage the co-administration of bactericidal plus bacteriostatic agents, thus the recommendation to avoid a cell wall drug combined with a tetracycline.
3. L-FORMS (SPHEROPLAST)- It has been recognized that B. burgdorferi can exist in at least two, and possibly three different morphologic forms: spirochete, spheroplast (or l-form), and the recently discovered cystic form (presently, there is controversy whether the cyst is different from the l-form). L-forms and cystic forms do not contain cell walls, and thus beta lactam antibiotics will not affect them. Spheroplasts seem to be susceptible to tetracyclines and the advanced erythromycin derivatives. Apparently, Bb can shift among the three forms during the course of the infection. Because of this, it may be necessary to cycle different classes of antibiotics and/or prescribe a combination of dissimilar agents.
4. CYSTIC FORM- When present in a hostile environment, such as growth medium lacking some nutrients, spinal fluid, or serum with certain antibiotics added, Bb can change from the spiral form (``spirochete'') into a cyst form. [b]This cyst seems to be able to remain dormant, but when placed into an environment more favorable to its growth, Bb can revert into the spirochete form.
The antibiotics commonly used for Lyme do not kill the cystic form of Bb. However, there is laboratory evidence that metronidazole and tinidazole will disrupt it. Therefore, the chronically infected patient who has resistant disease may need to have metronidazole (or tinidazole) added to the regimen. More details are provided in the section on treatment options.
This comes from Dr. B. You can find this information under the ILADS guidelines on their website. I encourage everyone to read those guidelines. Print them out, and read them wherever you're most comfortable.
They are priceless.
Posted by Rianna (Member # 11038) on :
Here is a document/link that gives lots of information and links to clinical studies on Life cycles, treatment etc