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Which ones have the most clout for neuro problems? IV Rocephin? Flagyl? Tindamax?
What else crosses the blood-brain-barrier? Any herbs?
Posts: 922 | From Philadelphia | Registered: Sep 2012
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TF
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"INDICATORS FOR PARENTERAL THERAPY (The following are guidelines only and are not meant to be absolute. It is based on retrospective study of over 600 patients with late Lyme disease.)
� Illness for greater than one year � Prior immunosuppressive therapy while infected with Bb. � Major neurological involvement.... " (page 21 of Burrascano Guidelines)
This says that IV is the best for major neuro symptoms. However, you can't be on just one medication. So, for example, you should be put on rocephin plus oral flagyl or another cyst buster.
Being on just IV rocephin has failed for many.
Here is another quote for you:
"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. 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." (pages 12-13)
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