Pulsed Antibiotics May Be a More Effective Dosing for Lyme Persisters.

Remy

Administrator
This study, found on Dr Holtorf's blog, suggests that cyclical antibiotic therapy may be more advantageous for eradicating persister Lyme cells.

They suggest that 5 days on/5 days off may be a better schedule than every day dosing. This gives the persister cells a chance to morph back into antibiotic susceptible cells.

Currently, the persister cells are not affected by antibiotic treatment. So this means that once the active spirochetes are killed, there's no point in taking antibiotics continuously if they have zero effect on the persister cells.

Of note, they also found that the antibiotic, mitomycin C, may kill persisters in a single low dose. Wouldn't it be something if that actually turns out to be the case?

A newly published study by the American Society for Microbiology may fundamentally change the way we view and treat chronic Lyme disease. While it has been well known that Borrelia burgdorferi (Lyme disease) has multiple methods to become resistant to antibiotics, this study demonstrates that it may not be an actual resistance (which is seen in many other bacteria), at all. Rather, this study demonstrates that Lyme has the ability to transform into a metabolically inactive form, called a persister cell. The metabolically inactive persister cells are essentially in a state of suspended animation. This lack of metabolic activity makes them totally resistant to any antibiotic at any dose and also any combination of antibiotics. This is in contrast to other methods that bacteria use to become resistant that can be overcome by using larger doses of antibiotics, different antibiotics or a combination of antibiotics. None of these strategies have any effect upon the persister cells. Upon regrowth back to the normal active form, which occurs when the antibiotic is removed, the persister cells have no antibiotic resistance. Such new knowledge may change the way Lyme disease is viewed and treated.

Is there any good news? Thankfully and hopefully, yes. This study showed that Lyme was rapidly killed, essentially equally with different antibiotics and independent of the dose. Again, once they transformed into persister cells, nothing worked. But if they were left alone and allowed to grow without any antibiotics, they reverted back to the standard form. This form was susceptible to antibiotics and was quickly killed. A small percentage again went into persister cell forms and became totally resistant but when they were left alone without antibiotics, they then reverted to standard form and became susceptible to the antibiotics. They found that four cycles essentially eradiated the infection. While real-life is, no doubt, more complex than what happens in a test tube, this may truly be a game changer.

It is truly unbelievable that standard infectious disease doctors refuse to acknowledge the thousands of studies demonstrating the existence of chronic Lyme disease in epidemic proportions. Based on the best available medical evidence, Lyme literate doctors generally use high doses of oral and IV antibiotics for long-periods of time. We, and many other such doctors, have used numerous combinations of antibiotics and antiparasitics in an attempt to counter the Lyme bacteria’s mechanisms of resistance. While this has proven to be more effective and to generate fewer side-effects than continuous long-term dosing, we have all worried that allowing too much time off of antibiotics would allow the Lyme to “regain a foot-hold” and ground gained would be lost. This study shows, however, that the key to successful long-term treatment may be allowing sufficient time off of antibiotics to allow the reconversion back to the standard form, then to “surprise” this relatively more defenseless form of Lyme. This strategy is then used over and over. Based on this study, a more appropriate dosing schedule may be five days on and five days off.

Interestingly, I myself had been taking one or two days of antibiotics every week or two as a precaution against a Lyme relapse, as I simply found that I feel better when I did this, even though such dosing is against standard infectious disease principles because it could theoretically contribute to the formation of resistant strains. This study shows that the key may not be the length of treatment, the antibiotic dose or the combination of antibiotics used, but rather the time off the antibiotics.

Another part of the study found the antibiotic mitomycin C, which is used as a chemotherapy agent against gastrointestinal cancer (potentially caused by an infectious agent), completely eradicated all persister cells with a single low dose. While this treatment still needs to be confirmed in clinical studies and is not without significant potential side-effects, such results should give the sickest of Lyme disease patients who have not responded to aggressive therapies a new found hope. A clinical therapeutic trail in a subset of the most ill, treatment resistant patients may be a reasonable approach.

Reference:
Sharma B, Brown AV, Matluck NE, et al. Borrelia bugdorferi, the causative agent of Lyme disease, forms drug-tolerant persister cells. Antimicrob. Agents Chemother 2015

@Strike me lucky, @outdamnspot
 

Horizon

Active Member
I had read antibiotics are only helpful when the organism is out and reproducing which happens once a month or so. The problem with that is you never know when to attack with tons of antibiotics.
 

Issie

Well-Known Member
I always pulsed when on Doxy. I was 3 days on and other days using antimalarial herbs. Worked good for 3 years. Then was exposed to mold and had a crash and nothing worked for awhile. Almost back on track now.

Issie
 

Cort

Founder of Health Rising and Phoenix Rising
Staff member
That is really interesting. I had never heard of persister cells before but they kind of remind of Naviaux's cells that turn inward and go into a defensive stance - they kind of go into hibernation...
 

Issie

Well-Known Member
Yeah, latest info on this is that Stevia helps with these cells. I've used Stevia for years. Wonder how bad I would have been without it.
Issie
 

Remy

Administrator
Here's what the article says about pulse dosing, @Strike me lucky :

Pulse dosing results in effective killing of B. burgdorferi persisters. Late exponential cultures of B. burgdorferi were treated with ceftriaxone (Cef) (3 g/ml) (a) or amoxicillin (Amox) (6 g/ml) (b) for 5 days. This represents the first round of killing. The cultures were then washed and allowed to recover in fresh BSK-II medium for 24 h. They were then treated again with amoxicillin (6 g/ml) or ceftriaxone (3 g/ml) for a further 5 days to give the second round of killing. This was repeated for a total of four rounds of killing with a 24-h period of growth in fresh medium between each round.

So, these are cells in culture...not a person, not even a mouse. So I have no idea what the ideal pulsing strategy would be for a person. They still need to do more testing. In the meanwhile, 5 on/5 off seems as reasonable as anything else.

Also of interest, they tested a bunch of abx in combination with one another to see if they acted synergistically and found no such relationships!

They also tested daptomycin, which was recently published as a treatment for Lyme persisters, and found it had no effect beyond other, more typical abx.

If anyone wants to read the whole thing, send me a PM.
 

Issie

Well-Known Member
So do any lyme gurus know how many cycles to rid or greatly lower lyme??

With the pulsing of abx is there die off symptoms when restarting abx after 3 to 5 days off?
I definitely have more muscle pain going back on abx after a short time off??
Yeah, more die off and herx. I've been working on it for 4 years now. But you want it to morph into the killable form. It can hide and not be detected otherwise.
Issie
 

Issie

Well-Known Member
Makes sense. Unsure if some of my current dymptoms are viral or die off.
Current 5 day pulse is roxithromycin and bactrim. Bactrim always seems to work well but not alot mentioned about it.
Are you using something to breakdown biofilm at least 2 hours or more before? I use that at night and then when I get up use my protozoa regimen.

Issie
 

Horizon

Active Member
Yeah, latest info on this is that Stevia helps with these cells. I've used Stevia for years. Wonder how bad I would have been without it.
Issie

Do you use the stevia while on abx? I heard stevia is a biofilm buster. If that's the case we can potentially feel awful on it if not on antibiotics at the same time.
 

Issie

Well-Known Member
Do you use the stevia while on abx? I heard stevia is a biofilm buster. If that's the case we can potentially feel awful on it if not on antibiotics at the same time.
I use herbals now. Not on antibiotics. I will have to do lifetime maintenance with Protomyzoa Rehumatica. I will never get rid of it. I have Lyme and another coinfection too.

Issie
 
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Who Me?

Well-Known Member
Do you use the stevia while on abx? I heard stevia is a biofilm buster. If that's the case we can potentially feel awful on it if not on antibiotics at the same time.
I use stevia all the time, have for years, and have no problems with it. Not on abx.
 

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