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» LymeNet Flash » Questions and Discussion » Medical Questions » Advantages of Pulse Therapy

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Author Topic: Advantages of Pulse Therapy
springshowers
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From Dr. B Guidelines

"PULSE THERAPY consists of administering antibiotics (usually parenteral ones) two to four days in a row per
week. This allows for several advantages:
* Dosages are doubled (ie: cefotaxime, 12 g daily), increasing efficacy
* More toxic medications can be used with increased safety (ie: vancomycin)
* May be effective when conventional, daily regimens have failed.
* IV access may be easier or more tolerable
* More agreeable lifestyle for the patient
* Often less costly than daily regimens
Note that this type of treatment is expected to continue for a minimum of ten weeks, and often must continue
beyond twenty weeks. The efficacy of this regimen is based on the fact that it takes 48 to 72 hours of
continuous bactericidal antibiotic levels to kill the spirochete, yet it will take longer than the four to five days
between pulses for the spirochetes to recover. As with all Lyme treatments, specific dosing and scheduling
must be tailored to the individual patient's clinical picture based upon the treating physician's best clinical
judgment."

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springshowers
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Who here PULSES their ABX.

And do you think that 3 days a week straight is better than M W F schedule???

What is your opinion on this?

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kareamber
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I just began pulsing. For 4 days I take Zirthromax, amox and then flagyl for the remainder 3 days.

I've been doing this for about two weeks and have noticed an increase in pain, but can't say it's working.

I was only taking Ceftin for 3 months will littler to no improvement, so I'm hoping the pulsing will be more beneficial.

I don't know if the 3 days straight is more benenficial than the M W F, but I would think so, just cause the constant level of antibiotics. This is just my opinion though.

--------------------
IgeneX IGG POS 30+ 31++++ 41++
IGM 30+ 31+++ 34IND 41IND 83-93IND
Quest NEG IGG 30 and 41 only

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springshowers
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I know there is one very popular doctor who does M W F and I am trying to find out what the theory is on it. I have been afraid to post even the initial of the doctor and it seems there is a high level of monitoring and nervousness around posting doctors names or even indicating who they are and what they do. SO. Not sure how I will find out.
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Erica741
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Springshowers: You must be referring to my LLMD. While I plan continue to adhere to LN's "rules" re. using doctor initials, this doctor has already been put through the legal ringer and continues to be public/outspoken...so there is really no need to be secretive.

My understanding of his M/W/F pulsing is this schedule is best for maximizing treatment efficacy and minimizing treatment toxicity. For us patients on IV, we are instructed to infuse lactated ringers and glutathione (if tolerated) on our off-tx days.

I suspect the m/w/f works because this doctor always uses high-dose IV and oral COMBOS. IV patients are ALWAYS on 2 IV abx at a time, and also new IV meds are replaced one at a time....so patient benefits from multiple IV combos.

Many of the doctor's disease and treatment theories are discussed in a published document viewable on his clinic website.

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seekhelp
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Did this doc move recently? [Smile]
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springshowers
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yes.. thank you for that infor Erica. Do you travel to see this doc and does the office work that out with you pretty well..?

I hear you on the reason for M W F but still am not sure that M T W at high doses is not better for me.

I like having more than 2 days
"off" and to regroup and let my body take a breath. If you know what I mean. I use Ringers and it helps a lot.

For me if you do a few days of HIT it Hard.. and then you give time to Detox .. then it helps to have just a couple days of just letting the body do its own thing...

IF you do M W F there is not much room for that..?

I guess I could do M W F every other week?

Just thinking out loud.

Also need some room to cycle in Cyst buster meds

I am in the middle of writing out an exact plan for myself that takes all these things into consideration...

Right now I am still on M T W for Abx with Th F S S off. But in those 4 days I cycle in a cyst busting oral med and artimisinin too and have been putting those in on S S M
Which leaves me Th F with Ringers and sometimes I add another day for that too such as Wed if I start herxing badly it helps.

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springshowers
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IF I change to M W F for IV ABXs...

That leaves me on S S for Pulsing in my Cyst meds and for Ringers.

Do you know how that is best done on a M W F schedule? Does he do the Ringers on T Th and S S ??

Do you know where i can find more specifics or can you PM?

Erica?

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Erica741
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Yes I do travel across the country to see this LLMD. Not exactly convenient of course...and rather hard as I am very sick on IV regimen.

However I simply had no choice but to switch to this MD if I want to get well, as I was unable to get adequate treatment on the w. coast.

This doctor is extremely diligent and organized, and has multiple RNs and and admin staff well-equippled to give individualized attention to his patients world-wide.

Re. med schedule: Why not pulse your orals on the same days as your IVs? I think you'd particularly need to take artemisinin the same day as your Mepron or whichever other antimalarial Rx(s) you are taking.

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lymednva
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My LLMD'S wife sees this LLMD, who just moved to DC and they have become friends. My LLMD uses the MWF pulsing schedule and I like it. I've been improving, too! [Smile]

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Lymednva

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springshowers
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Wow.. Great..

Erica. What do you mean pulse my orals on same days as IVs? do you mean... for
example.

If I do IV Doxy on M W F and want to pulse Flagyl.. Then Something like every other week add in IV Flagyl M W F.

I would be interested to hear how he does pulsing.

If either of you could help me understand his technique a little better.. And overall reasoning.

You do not have to give me specifics...

If you could tell me if the M W F is used for main meds for killing lyme. How does the cyst busters work around that? How does the antimalarias work around that too?

I really think highly of the doctor your seeing. I am trying to learn more about the techniques. If I could get across country. I would.
I am making progress now but if I stopped or had to do this again I would go see him for sure.

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swachsler
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fwiw, i do rocephin 4 days in a row, th3n 3 days off. on days 1 and 3 of off days i do bicillin and flagyl.

EVERY day i also take biaxin, plaqunil, cholestyramine, and nystatin.

i do artem 3 days on, 4 days off. it so happens that i do rocephin Sat, sun, mon, tues, and artem mon, tues ,wed, but that's just how it worked out, not cuz llmd say to overlap or not.

sharon

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