It would be a tough decision if i had to choose between Roxithromycin and Clarithromycin(biaxin). They both served well for me. It mainly depends on what you are trying to target. Roxithromycin combined with Bactrim for increased MIC values, did great in keeping the babesia sweating and muscle symptoms at bay. Roxy/Bactrim is also a good combo for lyme. Either one of them alone has a slight effect on lyme but even greater when combined. Outside of being an antibiotic, roxithromycin has some good antimalarial properties. So combined with other antimalarials such as artmenisin, mepron or bactrim for babesia is a good idea. I felt it did better as an add on to mepron versus zithromax or biaxin. Zithromax oral proved to be the most worthless abx i've taken. Not to say that the zithromax IV form doesn't have good results though.
I know a few others who are using roxithromycin and biaxin. I think they alternate the two every other week.
What do these flare ups consist of? How long have you been doing this combo of plaquenil, biaxin, doxy? Any minor night sweats, depression or muscle fatigue/pain? If so, you may be missing babesia. If not, plaquenil does take a few months to get full benefit.
I had horrible insomnia for the first 2 months on biaxin. At the time i thought i was a side effect but now when i look back it was clearly a herx and takes time to subside. Similar herxes are felt with rifampin. I think the only way around it for me without narcotics or herbal sleep remedies was to nap during the day, anytime i was tired.
Biaxin/Amoxicillin is another great lyme combo to try.
Minocycline may do some good, you never know until you try it. It does indeed have a dizziness side effect. I found that side effect never resolved so i eventually dropped it. I still choose doxy over minocycline. Doxy did well but only when combined with one or two other good abx such as the macrolides.
The cephalosporins are a different and more complicated story.
Post Edited (phsinvent) : 1/7/2009 3:42:12 PM (GMT-7)
Also keep in mind. Most of those bart symptoms listed are also lyme symptoms. Your sweats are the biggest indicator. They should lead you in the right direction. And your babs treatment was wayyyy too short. I myself loved Biaxin/plaquenil/doxy for bartonella. Roxy and bactm was good for bart too. Rifampin would only give you temporary relief because you really are almost out of options. So if you think it is bart, then why would biaxin/plaquenil and doxy not get you to a symptom free state? And why wasn't the IV cipro so special? And why did doxy, mepron, plaquenil, biaixin cause an increase in night sweats followed by less sweating and daytime fever? You need to ask yourself this. I honestly think you could be missing something. Actually something is missing because you have gone after bart and lyme but kind of neglected possible babesia. Did you ever try artmenisin. I'm sure this conversation will repeat itself down the road after you try rifampin, minocycline and levaquin. I think that route may be a dead end.
One last thing. When you did mepron zithromax. You claimed that you went downhill. Well think of this theory. We all know zithromax is pretty much worthless against lyme. And mepron isn't an antibiotic. Do you think the backslide could of been lyme gaining the upper hand but you were thinking you don't have babesia. It was like two things were happening at once.
I don't know. My LLMD gave me a sheet (prescription) with the test he wants. I was going to have my blood drawn at an outpatient center next Monday and have them send it out to the appropriate labs. Are testing for the co-infections bad (i.e. not reliable like lyme)?