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» LymeNet Flash » Questions and Discussion » Medical Questions » What are the most effective types of Oral Tetracyclines and Macrolides?

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Author Topic: What are the most effective types of Oral Tetracyclines and Macrolides?
adamttt
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Hi,

I have been advised by a LLMD, to take Oral Tetracyclines and oral Macrolides to attack my chronic lyme - neurplogical symptoms.

I was just wondering those that have taken this oral combination of abx, which forms a tetracyclins and mcrolides would you say are most effective in treating chronic 'neurological' lyme??

Just wanted opinions, not taking what people say as medical advice.

Thanks

Posts: 33 | From UK | Registered: Mar 2009  |  IP: Logged | Report this post to a Moderator
'Kete-tracker
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Combining these 2 classes is tricky. Usually the tetracyclines, like doxy, are used by themselves.
I know Dr B's guidelines recommends not to combine a tetracycline with a "cell wall" drug.

The best oral, macrolide-class drug to fight neuro-based Lyme- in MY opinion, as I read studies- is Suprax (cefiximine). It's $$, but a 90 day course is comparable in efficacy to 30 days of IV Rocephin followed by oral amoxy.

I know minocycline is often added with macrolides, but as I've never taken it, I'd refer you to others here, or a L.L.pharmacist. (They Do exist [Wink] )

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FunkOdyssey
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I don't see any problem with taking the two classes of drug simultaneously -- in fact they should have synergistic action and they do in some models of infection, including toxoplasmosis in rats.

They are both intracellular drugs but they have different tissue distribution and they target different areas of the bacterial ribosome, so they are complimentary.

Protocols for Multiple Sclerosis due to (or thought to be due to) chlamydia pneumoniae use minocycline or doxycycline with azithromycin or roxithromycin, and some versions also add tinidazole and rifampin. I wonder how many of them are unknowningly, yet successfully treating Lyme?

Posts: 195 | From Manchester, CT | Registered: Jun 2008  |  IP: Logged | Report this post to a Moderator
adamttt
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hmmm , FunkOdyssey, i have recently learnt that combination was used by a lymie successfully:

Oral Minocycline
and
Oral Azithromycin

Has anyone had success with this protocol for chornic lyme?

Does anyone know the recommended doses for this combination?

thank you

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FunkOdyssey
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Typically 500mg of azithromycin is used daily, and then minocycline dose depends on what the patient can tolerate. I've been prescribed 300mg of minocycline, which is considered a relatively high, Lyme effective dose, however I may try to push up to 400mg.
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Lymeorsomething
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How many people have used Suprax? I haven't seen this med discussed that often...

--------------------
"Whatever can go wrong will go wrong."

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adamttt
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i see, is the 500mg of azithromycin seperated - 250mg twice a day, or in one 500mg dose?

Did you take minocycline at the same time as azirthromycin?
Have you had symptom improvcement? how much better are you % wise with these abx?

[Smile]

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FunkOdyssey
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Azithromycin has a super, super long half-life and is generally given just once daily. I took azithromycin with mepron for a period of six weeks with little improvement. I haven't taken it together with a tetracycline drug.

I haven't started on the minocycline yet, I was just prescribed a new regimen which consists of:

bicillin 1.2mu 3x weekly
minocycline 300mg daily
rifampin 600mg daily
tinidazole 1500mg daily

I have only done one week of bicillin shots so far, I'm introducing them one-by-one, and I'll add minocycline on Monday. Only felt some herx type reaction on the first evening of the first bicillin shot, since then I've actually been feeling pretty good.

I was never extremely sick or non-functional, I was at maybe 40% at my worst and six months of various things (doxycycline alone, tetracycline alone, ceftin + biaxin, azithromycin + mepron) have brought me to maybe 55-60%.

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