Topic: Former LD patient says success for neuro LD with Biaxin combo
lymebytes
Frequent Contributor (1K+ posts)
Member # 11830
posted
Hi, You might have had this link posted here before, but I found it so especially interesting since I have neuro-lyme and have found Biaxin/Amoxi to be an amazing combo for me and am trying to find every reason not to change as my LLMD's press me.
treepatrol
Honored Contributor (10K+ posts)
Member # 4117
posted
Amoxicillin and doxycyline (penicillin & tetracycline) and Lyme disease. ************************************************************************ 26 May 1997 - updated 14 August 1999
Knowing that different antibiotics may work differently for different people at different dosages for different courses at different times for different strains of Bb, I make the following observations about the antibiotics amoxicillin and doxycycline and my battle with Lyme disease.
Background **************************************
No doubt of my Lyme disease diagnosis - tick bite, rash - reddish circles with slightly raised edges and lighter centers, many classic Lyme disease symptoms, and, nine months later with no antibiotic treatment, a positive Lyme disease titer.
After approximately four years of ups and downs with short term (3 to 6 weeks) IV Rocephin (ceftriaxone) and ineffective oral treatments, my local doctor agreed to one more 6 week IV Rocephin treatment followed by long term (one year or more) of treatment with the combination of doxycycline and Biaxin (clarithromycin). After approximately 9 months of this combination treatment, during which time all the Lyme disease symptoms did not disappear as they had during previous treatments, the major symptoms reappeared. I then, in the summer of 1995, had to find my current Lyme literate doctor.
My Lyme literate doctor and I decided to switch to the combination of Biaxin (500mg, twice per day) and amoxicillin (1500mg, four times per day - a total of 6.0 grams per day). This has made an enormous difference. After being on this combination for over three years, all symptoms have disappeared and my health continues to improve, even though I just recently stopped taking the Biaxin and have recently cut back to 1500mg of amoxicillin, two times per day. Why did amoxicillin work for me and doxycycline did not?
My guess **************************************
I hypothesize that, because I went so long before receiving my initial treatment (9 months) and/or because I required large dosages of IV and oral antibiotics, my immune system may have been compromised.
In the abstract that I have of Dr B's presentation at the 1995 Eighth Annual International Scientific Conference on Lyme Borreliosis and Tick-Borne Disease held in Vancouver, British Columbia, entitled "Management of Chronic Lyme Disease", Dr B states that "My studies have shown that many patients with resistant infections have deficiencies in B, T, and/or killer cell function."
Doxycycline prevents the bacteria from reproducing but does not directly kill the bacteria - it weakens them and they die or are killed by the immune system. This is what is referred to as bacteriostatic action and is dependent on a well functioning immune system. But if the immune system has been adversely affected by the disease or antibiotics, then it might not be able to cope with the bacteria.
On the other hand, amoxicillin, a penicillin, is bactericidal, meaning that it directly kills the bacteria, and does so while they are dividing (replicating). This may be the reason that amoxicillin has worked so well for me - it does not depend on a fully functioning immune system.
Other issues **************************************
1. Does amoxicillin penetrate the brain barrier?
The Physicians Desk Reference (PDR) and the little flyer that is included in the antibiotic container (very often removed by the pharmacist) states the following: "It [amoxicillin] diffuses readily into most body tissues and fluids, with the exception of brain and spinal fluid, except when meninges are inflamed."
However, Tom Grier, in his notes of Dr B's presentation at the 1995 Eighth Annual International Scientific Conference on Lyme Borreliosis and Tick-Borne Disease held in Vancouver, British Columbia, entitled "Management of Chronic Lyme Disease", writes "He [Dr B] emphasized that Neuro Syphilis is treated with 6000 mg Amoxicillin plus probenicid daily!". To me, this means that at high enough concentrations, amoxicillin does in fact penetrate the brain barrier.
Also, I found the following abstract on the subject (although this abstract addresses IV amoxicillin). Meningeal inflammation is mentioned because of a previous study which indicated that the blood brain barrier becomes more permeable in the presence of meningeal inflammation.
Title [Penetration of amoxicillin into the cerebrospinal fluid] Author Mingrino S; Scanarini M; Magliulo E Source Arch Sci Med (Torino), 138(1):33-5 1981 Jan-Mar Abstract The results of a study of the CSF concentration of i.v. amoxicillin in control subjects free of meningeal inflammation are presented. The drug proved capable of passing the blood-brain barrier when employed in sufficiently high doses, even in the absence of meningeal inflammation. The CSF level of the antibiotic was higher than the MIC required for most of the meningeal pathogens. Language Ita PMID: 7247702 UI: 81231666 http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=7247702&form=6&db=m&Dopt=b
And, from the Washington Post, "Emery Battles On and Off the Court", May 12, 1999:
"Dr.L [see Dr.L information below] diagnosed Lyme Disease about three years ago and put David on a strict regimen of antibiotics. Dr.L said Emery took approximately six grams of Amoxicillin a day, roughly six times what people would take on a daily basis for a cold.
"I had to take 12 pills of Amoxicillin a day," Emery recalled. "I was happy that a doctor finally knew what was wrong with me. I was so tired of going to all the different doctors."
My personal experience is that amoxicillin at high dosage (6 grams per day - 1500mg, four times a day for two years - i.e., the same 12 capsules per day taken by Emery in the story above) has alleviated all of my Lyme disease symptoms including my neurological symptoms.
Even though three separate previous treatments with Rocephin IV also cleared up my symptoms, I always relapsed. Treatment #1: 3 weeks of Rocephin followed by 30 days of doxycycline, treatment #2: 3 weeks of Rocephin followed by 6 months of doxycycline, and treatment #3: 6 weeks of Rocephin followed by one year of doxycycline in combination with Biaxin - I actually felt myself relapsing after six months into the doxycycline/Biaxin.
My conclusion: Amoxicillin will penetrate the blood brain barrier (BBB) if taken in sufficiently high dosages.
----- The amoxicillin aleviated reoccurring headaches which I think are associated with neurological infection. Since being on amoxicillin (6000 mg per day - yes, that's 6.0 grams per day - three, 500mg capsules, four times a day) I have had no return of symptoms, including neurological symptoms. As of 11 March 1998, I'm down to three grams of amoxicillin per day and I feel great.
2. Can one benefit by taking doxycycline and amoxicillin at the same time?
The PDR and drug flyers also state for doxycycline, under "Drug Interactions", "Since bacteriostatic drugs may interfere with the bactericidal action of penicillin, it is advisable to avoid giving tetracyclines [like doxycycline] in conjunction with penicillin [like amoxicillin]."
The way I read this is that, it's not so much that the chemicals counteract or cancel each other, it's that if doxycycline has prevented the bacteria from replicating, then the amoxicillin will have no effect since it depends on the bacteria replicating. However, I have my doubts that all of the bacteria are affected at the same time by doxycycline and that amoxicillin may kill some bacteria at the same time that doxycycline is having its affect. And besides, my motto is, if it works for you, use it!
-------------------- Do unto others as you would have them do unto you. Remember Iam not a Doctor Just someone struggling like you with Tick Borne Diseases.
treepatrol
Honored Contributor (10K+ posts)
Member # 4117
posted
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-------------------- Do unto others as you would have them do unto you. Remember Iam not a Doctor Just someone struggling like you with Tick Borne Diseases.
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