What has helped you the most from abx for Bart?

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greatguy
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Date Joined Dec 2017
Total Posts : 104
   Posted 1/11/2018 8:46 AM (GMT -6)   
Looks like from my research, Bart is the hardest to kill? So what then are the best abx for it? I know quinolones are very good, but they are the hardest on the body with the most side effects.


Is Doxy daily 400 mg or 2 pills x 2 times a day, Bactrim daily x 2 times a day, Azithromycin pulsed 500 mg (M+W+F) and Flagyl pulsed (Sat+Sun) a good regimen? Will i explode?

Post Edited (greatguy) : 1/11/2018 8:35:50 AM (GMT-7)


Kat1000
Veteran Member


Date Joined Feb 2017
Total Posts : 666
   Posted 1/11/2018 10:04 AM (GMT -6)   
Currently taking rifampin for 30 days. I've tried taking it before with mino or doxy, and it starts bothering my stomach within 2 weeks. This time LLMD has me doing rifampin only and buhner's
pos for MTHTR single mutation; Positive Igenix IgG Jan 2017
March/Apr '17: doxy, Tinizadole. 5/1 samento and exchange mino for doxy. 5/28- switch mino back to doxy, added activated charcoal. 6/9 - stopped antibiox; staying with samento, red root and houttiya and supps. 7/10 added LDN; 8/24 rifampin, samento, red root and supps

Girlie
Forum Moderator


Date Joined May 2014
Total Posts : 32609
   Posted 1/11/2018 1:07 PM (GMT -6)   
greatguy said...
Looks like from my research, Bart is the hardest to kill? So what then are the best abx for it? I know quinolones are very good, but they are the hardest on the body with the most side effects.


Is Doxy daily 400 mg or 2 pills x 2 times a day, Bactrim daily x 2 times a day, Azithromycin pulsed 500 mg (M+W+F) and Flagyl pulsed (Sat+Sun) a good regimen? Will i explode?


Bactrim has limited effectiveness. I know a few people who have used Bactrim with a Macrolide, but their infections were months (less than a year) old...that may be the difference.

Rifabutin or Rifampin is next after the fluoroquinolones.
Moderator, Lyme Forum
Symp started April/2013; Buhner's Lyme May 15-July24/14; Igenex pos. July 3/14
Doxy: July 4-Aug.24/14;Zithro July26-Aug24/14; Amox + Proben. Aug. 29/14;
added biaxin Sept. 26/14
Disc. amox,added Ceftin Nov. 20th.;
Disc. biaxin added Buhner bart herbs Dec/14;Jan/15 pulsing Tinda (w/ Ceftin);
Abx/herb break Apr-July/15; July-mino; Aug. added Rif;
Nov./15 mino - to biaxi

greatguy
Regular Member


Date Joined Dec 2017
Total Posts : 104
   Posted 1/11/2018 1:36 PM (GMT -6)   
Girlie said...
greatguy said...
Looks like from my research, Bart is the hardest to kill? So what then are the best abx for it? I know quinolones are very good, but they are the hardest on the body with the most side effects.


Is Doxy daily 400 mg or 2 pills x 2 times a day, Bactrim daily x 2 times a day, Azithromycin pulsed 500 mg (M+W+F) and Flagyl pulsed (Sat+Sun) a good regimen? Will i explode?


Bactrim has limited effectiveness. I know a few people who have used Bactrim with a Macrolide, but their infections were months (less than a year) old...that may be the difference.

Rifabutin or Rifampin is next after the fluoroquinolones.


But you took Bactrim (not DS) probably yourself. I really didn't understand why you wrote what you wrote in teh first place. Bactrim has been shown by Zhang research that just like any other Sulfa drug like Dapsone, is going to kill, but not eradicate Bart. The point is no amount of Doxy or Macrolides are going to do even that.

tickbite666
Veteran Member


Date Joined Mar 2014
Total Posts : 1603
   Posted 1/11/2018 2:19 PM (GMT -6)   
Cipro, Tetracycline, Plaquenil, CSA, Cat's Claw, JK helped me the most.

Currently pulsing Tetra, Alinia, Diflucan, and taking Hout, JK Plus, and GSE full time.

Some Bart and Bb persistors remain

Girlie
Forum Moderator


Date Joined May 2014
Total Posts : 32609
   Posted 1/11/2018 2:20 PM (GMT -6)   
greatguy - not sure what you're saying.


Yes, one LLND prescribe bactrim for me...I think I had a couple weeks worth. But, it wasn't specifically prescribe to me for bartonella.
It's what she prescribes prior to doing the LDI. I had seen her for that.

It is a good lyme drug....but generally isn't 'enough' for bartonella.
That's why Rifabutin and Rifampin are used (also fluoroquinolones - but many of us don't want to take them...or have tried and had to stop)

"The point is no amount of Doxy or Macrolides are going to do even that."

Yes, that's true (except maybe if caught early on) - so you will want to take Rifabutin...or Rifampin.

I did get results with Rifampin.
Moderator, Lyme Forum
Symp started April/2013; Buhner's Lyme May 15-July24/14; Igenex pos. July 3/14
Doxy: July 4-Aug.24/14;Zithro July26-Aug24/14; Amox + Proben. Aug. 29/14;
added biaxin Sept. 26/14
Disc. amox,added Ceftin Nov. 20th.;
Disc. biaxin added Buhner bart herbs Dec/14;Jan/15 pulsing Tinda (w/ Ceftin);
Abx/herb break Apr-July/15; July-mino; Aug. added Rif;
Nov./15 mino - to biaxi

greatguy
Regular Member


Date Joined Dec 2017
Total Posts : 104
   Posted 1/11/2018 3:37 PM (GMT -6)   
Rifampin doesn't penetrate into the brain, Bactrim does. If bart is causing brain fog and tinnitus, rifampin won't help?

Girlie
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Date Joined May 2014
Total Posts : 32609
   Posted 1/11/2018 3:56 PM (GMT -6)   
I have read that Rifampin does get into the CSF but not the brain tissue.

Depends on what's causing the tinnitus. Is it a nerve issue?


I have/had pulsatile tinnitus...it's almost gone now. One ear it is...other one it's barely there.

i don't know if it was lyme/bart/babs...

I heard an interview with Dr. J. and he said that the antibiotics can get through to the brain via the blood/brain barrier...or through vascular channels.

Here's the link. I think it's around the 20 minute mark.




/lymediseaseuk.com/2017/05/20/dr-joseph-jemsek-q-a-video/
Moderator, Lyme Forum
Symp started April/2013; Buhner's Lyme May 15-July24/14; Igenex pos. July 3/14
Doxy: July 4-Aug.24/14;Zithro July26-Aug24/14; Amox + Proben. Aug. 29/14;
added biaxin Sept. 26/14
Disc. amox,added Ceftin Nov. 20th.;
Disc. biaxin added Buhner bart herbs Dec/14;Jan/15 pulsing Tinda (w/ Ceftin);
Abx/herb break Apr-July/15; July-mino; Aug. added Rif;
Nov./15 mino - to biaxi

greatguy
Regular Member


Date Joined Dec 2017
Total Posts : 104
   Posted 1/11/2018 4:09 PM (GMT -6)   
Bart is known to cause these kind of bizzare symptoms. Babs unlikely and lyme mainly affects joint/muscle pain and brain fog, and CAN get into something much more complex if there is autoimmunity with MS and such.

The reason for that, is that bartonella is completely unheard of even among lyme IDSA doctors (not ILADS) and you'd think that if it was a problem, it would be way more addresed, just like toxoplasmosis in AIDS patient.

There's one video of one vet from a vet clinic in Raleigh, that specifically says, if it weren't for AIDS patients having bartonella, probably not even Lyme docs would had known anything about it.

So it just goes to show how little research is being put into Lyme and how 10x less is there into Bartonella.

Girlie
Forum Moderator


Date Joined May 2014
Total Posts : 32609
   Posted 1/11/2018 5:04 PM (GMT -6)   
greatguy said...
Bart is known to cause these kind of bizzare symptoms. Babs unlikely and lyme mainly affects joint/muscle pain and brain fog, and CAN get into something much more complex if there is autoimmunity with MS and such.

The reason for that, is that bartonella is completely unheard of even among lyme IDSA doctors (not ILADS) and you'd think that if it was a problem, it would be way more addresed, just like toxoplasmosis in AIDS patient.

There's one video of one vet from a vet clinic in Raleigh, that specifically says, if it weren't for AIDS patients having bartonella, probably not even Lyme docs would had known anything about it.

So it just goes to show how little research is being put into Lyme and how 10x less is there into Bartonella.


babesia causes ANS issues (Autonomic nervous system) - that's likely what my POTS symptoms are from, as well as tinnitus.
But Bartonella also affects the nervous system.

Bartonella is known but it is usually 'self-limiting' - except for those with compromised immune function - like us with lyme.
Moderator, Lyme Forum
Symp started April/2013; Buhner's Lyme May 15-July24/14; Igenex pos. July 3/14
Doxy: July 4-Aug.24/14;Zithro July26-Aug24/14; Amox + Proben. Aug. 29/14;
added biaxin Sept. 26/14
Disc. amox,added Ceftin Nov. 20th.;
Disc. biaxin added Buhner bart herbs Dec/14;Jan/15 pulsing Tinda (w/ Ceftin);
Abx/herb break Apr-July/15; July-mino; Aug. added Rif;
Nov./15 mino - to biaxi

Sheeks175
Regular Member


Date Joined May 2016
Total Posts : 257
   Posted 1/11/2018 5:44 PM (GMT -6)   
Girlie said...
greatguy said...
Bart is known to cause these kind of bizzare symptoms. Babs unlikely and lyme mainly affects joint/muscle pain and brain fog, and CAN get into something much more complex if there is autoimmunity with MS and such.

The reason for that, is that bartonella is completely unheard of even among lyme IDSA doctors (not ILADS) and you'd think that if it was a problem, it would be way more addresed, just like toxoplasmosis in AIDS patient.

There's one video of one vet from a vet clinic in Raleigh, that specifically says, if it weren't for AIDS patients having bartonella, probably not even Lyme docs would had known anything about it.

So it just goes to show how little research is being put into Lyme and how 10x less is there into Bartonella.


babesia causes ANS issues (Autonomic nervous system) - that's likely what my POTS symptoms are from, as well as tinnitus.
But Bartonella also affects the nervous system.

Bartonella is known but it is usually 'self-limiting' - except for those with compromised immune function - like us with lyme.


That's interesting about Babesia and POTS. I haven't read that anywhere, but I haven't done a lot of babesia research recently. However, I have been treating babesia like a beast lately. 6 pills malarone per day, liposomal artemisinin, and alinia 3 weeks on 3 weeks off and my heart symptoms have greatly improved. Biggest improvement in my treatment that I have had so far.


As far as bart treatments go:

A good combo: Minocycline, Rifampin, Bactrim DS. All 3 can be used together per LLMD MR. Try to use mino instead of Doxy as rifampin lowers doxy levels in the blood. You could rotate in zithromax, but I believe it isn't as strong as the 3 listed above. Biaxin can also be used, but rifampin lowers its levels too.

Quinolones. Cipro has less potential for side effects than levaquin, but is weaker. Try cipro first, I wouldn't worry about side effects too much. You can use magnesium to minimize risk of side effects. Also, maybe pulse cipro to reduce risk. If cipro is ok, then consider moving up to levaquin.

Herbals that work should be combined with bart abx: Houttuynia, Artemisinin, Oil of Oregano, Sida Acuta. (Liposomal Artemisinin and OoO are available at Hopkinton Drug and absorb into the blood the best)

Pyrazinamide is a persistor med for lyme and bart. This could be added in to a combination with rifampin and mino. This could be a great drug for bart. You can read up on Pyrazinamide protocols in Dr. Horowitz's new book.

Girlie
Forum Moderator


Date Joined May 2014
Total Posts : 32609
   Posted 1/11/2018 7:14 PM (GMT -6)   
Sheeks - I think it's Suzy Cohen's list of Babs symptoms that has POTS (which is ANS dysfunction)

I'll see if I can find it


Here it is

/suzycohen.com/articles/lyme_babesia_treatment/
Moderator, Lyme Forum
Symp started April/2013; Buhner's Lyme May 15-July24/14; Igenex pos. July 3/14
Doxy: July 4-Aug.24/14;Zithro July26-Aug24/14; Amox + Proben. Aug. 29/14;
added biaxin Sept. 26/14
Disc. amox,added Ceftin Nov. 20th.;
Disc. biaxin added Buhner bart herbs Dec/14;Jan/15 pulsing Tinda (w/ Ceftin);
Abx/herb break Apr-July/15; July-mino; Aug. added Rif;
Nov./15 mino - to biaxi

Post Edited (Girlie) : 1/11/2018 6:19:40 PM (GMT-7)


Rikky1
Veteran Member


Date Joined Jun 2015
Total Posts : 2860
   Posted 1/11/2018 7:22 PM (GMT -6)   
Agree with Sheeks I made the most progress on my nerve issues when taking Rifampin, Bactrim and Minocycline.

Problem is none of it was sustained because per Dr. J in DC my babesia duncani was blocking any consistent progress so I had to remove that first even though I was getting very little symptoms from it. So I've been treating Babesia for almost a year and its pretty much gone (per Dr. J) so next I see him we're going to switch to go after Bart and persisters.

I will be starting back up on Rifabutin (Dr. J likes this over Rifampin due to longer half life and wider/deeper penetration), Dapsone, Daraprim, Alinia and not sure what else.

I've been waiting a LONG time to start going after Bartonella again (or whatever gram negative pathogen is kicking my butt) almost a year while I've been managing the symptoms from it for all this time while eliminating Babesia.

As greatguy said Bactrim will not eradicate Babesia or Bart but will kill some of it and keep them from progressing too much. Bactrim is also a mild biofilm buster. I've been on it close to 18 months if you can believe that.

Sheeks175
Regular Member


Date Joined May 2016
Total Posts : 257
   Posted 1/11/2018 7:57 PM (GMT -6)   
Rikky1 said...
Agree with Sheeks I made the most progress on my nerve issues when taking Rifampin, Bactrim and Minocycline.

Problem is none of it was sustained because per Dr. J in DC my babesia duncani was blocking any consistent progress so I had to remove that first even though I was getting very little symptoms from it. So I've been treating Babesia for almost a year and its pretty much gone (per Dr. J) so next I see him we're going to switch to go after Bart and persisters.

I will be starting back up on Rifabutin (Dr. J likes this over Rifampin due to longer half life and wider/deeper penetration), Dapsone, Daraprim, Alinia and not sure what else.

I've been waiting a LONG time to start going after Bartonella again (or whatever gram negative pathogen is kicking my butt) almost a year while I've been managing the symptoms from it for all this time while eliminating Babesia.

As greatguy said Bactrim will not eradicate Babesia or Bart but will kill some of it and keep them from progressing too much. Bactrim is also a mild biofilm buster. I've been on it close to 18 months if you can believe that.


Has some activity against persistor Bb too! Wish I wasn't allergic. I'd be all over that.

Girlie
Forum Moderator


Date Joined May 2014
Total Posts : 32609
   Posted 1/11/2018 8:05 PM (GMT -6)   
Sheeks - you said:

"As far as bart treatments go:


.........Quinolones. Cipro has less potential for side effects than levaquin, but is weaker. Try cipro first, I wouldn't worry about side effects too much. You can use magnesium to minimize risk of side effects. Also, maybe pulse cipro to reduce risk. If cipro is ok, then consider moving up to levaquin.

Herbals that work should be combined with bart abx: Houttuynia, Artemisinin, Oil of Oregano, Sida Acuta. (Liposomal Artemisinin and OoO are available at Hopkinton Drug and absorb into the blood the best)"

-------------------------------------------------------


It is definitely something to consider (side effects).
They are serious enough for the FDA to put a black box warning on the label.

So everyone should know the harmful side effects (tendon rupture as well as peripheral neuropathy) since they are potential irreversible.

However, these infections are also wreaking havoc in our brain/body and we are not without 'risks' leaving the infections unchecked indefinitely.
Moderator, Lyme Forum
Symp started April/2013; Buhner's Lyme May 15-July24/14; Igenex pos. July 3/14
Doxy: July 4-Aug.24/14;Zithro July26-Aug24/14; Amox + Proben. Aug. 29/14;
added biaxin Sept. 26/14
Disc. amox,added Ceftin Nov. 20th.;
Disc. biaxin added Buhner bart herbs Dec/14;Jan/15 pulsing Tinda (w/ Ceftin);
Abx/herb break Apr-July/15; July-mino; Aug. added Rif;
Nov./15 mino - to biaxi

Sheeks175
Regular Member


Date Joined May 2016
Total Posts : 257
   Posted 1/12/2018 12:52 AM (GMT -6)   
Girlie said...
Sheeks - you said:

"As far as bart treatments go:


.........Quinolones. Cipro has less potential for side effects than levaquin, but is weaker. Try cipro first, I wouldn't worry about side effects too much. You can use magnesium to minimize risk of side effects. Also, maybe pulse cipro to reduce risk. If cipro is ok, then consider moving up to levaquin.

Herbals that work should be combined with bart abx: Houttuynia, Artemisinin, Oil of Oregano, Sida Acuta. (Liposomal Artemisinin and OoO are available at Hopkinton Drug and absorb into the blood the best)"

-------------------------------------------------------


It is definitely something to consider (side effects).
They are serious enough for the FDA to put a black box warning on the label.

So everyone should know the harmful side effects (tendon rupture as well as peripheral neuropathy) since they are potential irreversible.

However, these infections are also wreaking havoc in our brain/body and we are not without 'risks' leaving the infections unchecked indefinitely.


Every pharmacist and doctor should tell you about potential side effects and you should consider them before taking a drug. Pharmacists and drug manufacturers are legally obligated provide you with information about the medications side effects every time you fill your prescription. Even flagyl has a warning about it giving mice cancer. I hope you didn't misunderstand me. I just believe people think that these side effects are much more common than they really are. Sometimes the internet isn't always the most reliable source of medical information... Dr J prescribes them for Bart quite often. Same with Dr H. Same with Dr. M R. How many of their patients have been "floxed"? I imagine none or hardly any because they know how to prescribe in a safe manner. Even my mom prescribed cipro and levaquin to the elderly throughout her 35+ year career as a nurse and not one of them reported tendon problems. I would imagine the elderly are higher risk for tendon damage since their body isn't in the best shape, but lower risk in terms of duration when compared to lyme patients having to treat for multiple months. Maybe pulsing is the best option? I don't know. Again, just my opinion.

I dug up some real data on the topic of:

LEVAQUIN

Nervous system

Cases of sensory or sensorimotor axonal polyneuropathy (affecting small and/or large axons) resulting in paresthesias, hypoesthesias, dysesthesias, and weakness have been reported.

One survey reported 33 cases of peripheral neuropathy associated with this drug, ranging in severity from mild and reversible to severe and persistent. In 1 case, a 51-year-old female developed "electrical" sensations, numbness, allodynia, multiple severe tendinitis, partial tendon rupture, impaired memory, confusion, and impaired concentration, with some symptoms persisting after 1 year.[Ref]

Common (1% to 10%): Headache, dizziness
Uncommon (0.1% to 1%): Convulsions, hyperkinesias, hypertonia, paresthesia, somnolence, tremor, vertigo, abnormal gait, syncope, dysgeusia
Rare (0.01% to 0.1%): Tinnitus
Frequency not reported: Abnormal coordination, coma, hypoesthesia, dysesthesia, weakness, involuntary muscle contractions, hyperesthesia, paralysis, speech disorder, stupor, encephalopathy, leg cramps, ataxia, migraine, seizures, benign intracranial hypertension, hearing loss, hearing impaired, peripheral sensory neuropathy/sensory axonal polyneuropathy, peripheral sensory motor neuropathy/sensorimotor axonal polyneuropathy, dyskinesia, extrapyramidal disorder, hypoglycemic coma
Postmarketing reports: Abnormal electroencephalogram (EEG), exacerbation of myasthenia gravis, anosmia, ageusia, parosmia, encephalopathy (isolated reports), pseudotumor cerebri, hypoacusis, peripheral neuropathy (sometimes irreversible)

Frequency not reported. Aka too low to mention. Lower than rare.



Musculoskeletal

Achilles tendon rupture occurred in 4 of 489 study patients (3217 treatment days) after 1 to 10 days of this drug.

Uncommon (0.1% to 1%): Arthralgia, myalgia, skeletal pain, tendinitis
Rare (0.01% to 0.1%): Tendon disorders (including tendinitis [e.g., Achilles tendon]), muscular weakness
Frequency not reported: Arthritis, arthrosis, pathological fracture, osteomyelitis, synovitis , back pain, ligament rupture
Postmarketing reports: Tendon rupture (e.g., Achilles tendon), muscle injury (including rupture), increased muscle enzymes, rhabdomyolysis


Nebulizer Solution:
-Common (1% to 10%): Arthralgia, myalgia
-Uncommon (0.1% to 1%): Tendinitis, costochondritis, joint stiffness

.01 - 1% is actually slightly concerning to me. 1% actually might be a risk I am not willing to take unless my LLMD puts in measures that will lower that risk of levaquin side effects, such as magnesium and pulsing.



CIPRO

Nervous system

Seizures have been reported in 2 patients given this drug and foscarnet. The temporal association between the onset of seizures and drug administration suggests a possible drug interaction; causal relationship was not established in either case. Both drugs are individually epileptogenic; concurrent use may potentiate risk of seizures.

Cases of sensory or sensorimotor axonal polyneuropathy (affecting small and/or large axons) resulting in paresthesias, hypoesthesias, dysesthesias, and weakness have been reported.

One survey reported 11 cases of peripheral neuropathy associated with this drug. The severity ranged from mild and reversible to severe and persistent. In 1 case, a 44-year-old female developed numbness, allodynia, hypoesthesia, tremors, electrical and diffuse burning sensations, twitching, disorientation, visual impairment, nausea, temperature intolerance, rash, and palpitations; she remained disabled after 29 months. - (Sounds like lyme or bart. Am I right???? I bet it stirred an infection up.)

Nystagmus, anosmia, hyperesthesia, hypoesthesia, hypertonia, intracranial hypertension, and exacerbation of myasthenia gravis have also been reported during postmarketing experience.[Ref]

Common (1% to 10%): Headache, dizziness/lightheadedness, central nervous system disturbance
Uncommon (0.1% to 1%): Sleep disorders, taste disorders, seizures (including status epilepticus), dysesthesia, paresthesia, vertigo, hearing loss
Rare (0.01% to 0.1%): Syncope, hypoesthesia, tremor, tinnitus, migraine, olfactory nerve disorders, smell disorders, hearing impaired
Very rare (less than 0.01%): Disturbed coordination, intracranial hypertension, benign intracranial hypertension/pseudotumor cerebri, exacerbation of myasthenia gravis, hyperesthesia
Frequency not reported: Unresponsiveness, ataxia, hypertonia, anosmia, nystagmus, taste perversion/bad taste, somnolence/drowsiness, incoordination, disturbance in attention, dyskinesia, myasthenia gravis, paresis, aseptic meningitis, cerebral thrombosis, grand mal convulsion, dysphasia, lethargy, sensory axonal polyneuropathy, sensorimotor axonal polyneuropathy
Postmarketing reports: Taste loss, peripheral neuropathy (may be irreversible), polyneuropathy[Ref]




Musculoskeletal

Uncommon (0.1% to 1%): Musculoskeletal pain (e.g., extremity pain, back pain, chest pain), arthralgia
Rare (0.01% to 0.1%): Myalgia, arthritis, increased muscle tone and cramping, tendon rupture (mainly Achilles tendon)
Very rare (less than 0.01%): Tendinitis, muscular weakness
Frequency not reported: Arthropathy (including suspected reversible cases), joint stiffness, elevated serum creatine phosphokinase, abnormal joint exam, joint sprains, arthrosis, bone pain, decreased range of motion in a joint (knee, elbow, ankle, hip, wrist, shoulder), jaw pain, neck pain, gout flare-up, joint swelling, muscle spasms, night cramps, knee inflammation
Postmarketing reports: Myoclonus, myasthenia, twitching[Ref]


Arthropathy has primarily been a concern in pediatric patients; however, at least 1 case was described in an adult cystic fibrosis patient receiving this drug. Although cystic fibrosis arthropathy and hypertrophic pulmonary osteoarthropathy typically occur in 7% to 8% of cystic fibrosis adults and adolescents, the arthropathy exhibited in this patient did not resemble either. Several elements in its presentation strongly supported the diagnosis of ciprofloxacin-induced arthropathy, such as: a consistent time of onset with other reported cases of suspected quinolone-induced arthropathy (usually 3 weeks after starting therapy); a lack of history of arthralgia in the patient; reoccurrence upon rechallenge; and resolution of symptoms upon discontinuation of therapy (usually 2 weeks after therapy stopped).

Tendinitis with subsequent tendon rupture has been documented in numerous case reports. One patient with chronic renal failure developed bilateral Achilles tendon rupture after 4 days of ciprofloxacin therapy. Although renal transplant patients and those with end-stage renal disease tend to have an increased risk of Achilles tendinitis and rupture over the general population, quinolone use has been shown to further increase that risk (12% in quinolone-treated patients versus 7% in nonquinolone-treated patients).

As of October 1994, 25 cases of Achilles tendon rupture had been reported to the US FDA. Some ruptures have also occurred in the hand or shoulder. Other risk factors identified included age and corticosteroid use.

There had been 23 reports of tendinitis submitted to the Australian Adverse Drug Reactions Committee (ADRAC) between 2006 and 2008, including reports of Achilles tendinitis, tendon rupture, and tendon pain and swelling. The reports were primarily in male patients (15 cases) older than 56 years who used this drug for 2 to 14 days. In 19 of the reported cases, a fluoroquinolone (generally ciprofloxacin) was the primary suspect; however, details of concomitant serious medical conditions were not documented in most of the reports.

Musculoskeletal side effects reported in pediatric patients included arthralgia, abnormal gait, abnormal joint exam, joint sprains, leg pain, back pain, arthrosis, bone pain, pain, myalgia, arm pain, and decreased range of motion in a joint (knee, elbow, ankle, hip, wrist, shoulder).

Myalgia, tendinitis, and tendon rupture have also been reported during postmarketing experience.[Ref]



Interesting to note arthralgia is in .1 - 1% of patients taking cipro. That is also slightly concerning. Something I didn't know. I guess I already have arthralgia so I don't have to worry scool

Post Edited (Sheeks175) : 1/12/2018 12:32:11 AM (GMT-7)


Girlie
Forum Moderator


Date Joined May 2014
Total Posts : 32609
   Posted 1/12/2018 1:12 AM (GMT -6)   
Sheeks175 said...
Girlie said...
Sheeks - you said:

"As far as bart treatments go:


.........Quinolones. Cipro has less potential for side effects than levaquin, but is weaker. Try cipro first, I wouldn't worry about side effects too much. You can use magnesium to minimize risk of side effects. Also, maybe pulse cipro to reduce risk. If cipro is ok, then consider moving up to levaquin.

Herbals that work should be combined with bart abx: Houttuynia, Artemisinin, Oil of Oregano, Sida Acuta. (Liposomal Artemisinin and OoO are available at Hopkinton Drug and absorb into the blood the best)"

-------------------------------------------------------


It is definitely something to consider (side effects).
They are serious enough for the FDA to put a black box warning on the label.

So everyone should know the harmful side effects (tendon rupture as well as peripheral neuropathy) since they are potential irreversible.

However, these infections are also wreaking havoc in our brain/body and we are not without 'risks' leaving the infections unchecked indefinitely.


Every pharmacist and doctor should tell you about potential side effects and you should consider them before taking a drug. Pharmacists and drug manufacturers are legally obligated provide you with information about the medications side effects every time you fill your prescription. Even flagyl has a warning about it giving mice cancer. I hope you didn't misunderstand me. I just believe people think that these side effects are much more common than they really are. Sometimes the internet isn't always the most reliable source of medical information... Dr J prescribes them for Bart quite often. Same with Dr H. Same with Dr. M R. How many of their patients have been "floxed"? I imagine none or hardly any because they know how to prescribe in a safe manner. Even my mom prescribed cipro and levaquin to the elderly throughout her 35+ year career as a nurse and not one of them reported tendon problems. I would imagine the elderly are higher risk for tendon damage since their body isn't in the best shape, but lower risk in terms of duration when compared to lyme patients having to treat for multiple months. Maybe pulsing is the best option? I don't know. Again, just my opinion.


It was your statement "I wouldn't worry about side effects much".
Not many of the antibiotics have a black box warning - so when there is one...it should be considered...when deciding to take the med.
We have a member on this forum who was floxed.

And the FDA came out with this warning in 2016:

“The U.S. Food and Drug Administration is advising that the serious side effects associated with fluoroquinolone antibacterial drugs generally outweigh the benefits for patients with sinusitis, bronchitis, and uncomplicated urinary tract infections who have other treatment options. For patients with these conditions, fluoroquinolone should be reserved for those who do not have alternative treatment options."

/www.peoplespharmacy.com/2016/05/12/new-fda-warning-for-popular-cipro-and-levaquin-antibiotics/

My MIL had a tendon rupture in her right arm several years ago....We recently had a discussion with her Dr. about it - it happened during a time that she was on cipro periodically for UTI's.

*** I am not saying that no one should take it to treat these infections. I am saying that everyone should know the risks...and decide whether or not they want to try another med instead.
Moderator, Lyme Forum
Symp started April/2013; Buhner's Lyme May 15-July24/14; Igenex pos. July 3/14
Doxy: July 4-Aug.24/14;Zithro July26-Aug24/14; Amox + Proben. Aug. 29/14;
added biaxin Sept. 26/14
Disc. amox,added Ceftin Nov. 20th.;
Disc. biaxin added Buhner bart herbs Dec/14;Jan/15 pulsing Tinda (w/ Ceftin);
Abx/herb break Apr-July/15; July-mino; Aug. added Rif;
Nov./15 mino - to biaxi

Post Edited (Girlie) : 1/12/2018 12:16:35 AM (GMT-7)


Sheeks175
Regular Member


Date Joined May 2016
Total Posts : 257
   Posted 1/12/2018 1:39 AM (GMT -6)   
“The U.S. Food and Drug Administration is advising that the serious side effects associated with fluoroquinolone antibacterial drugs generally outweigh the benefits for patients with sinusitis, bronchitis, and uncomplicated urinary tract infections who have other treatment options. For patients with these conditions, fluoroquinolone should be reserved for those who do not have alternative treatment options."

Unfortunately for bad bart cases, if rifampin/rifabutin fails, the next best option is the quinolones. If you have another option as in the infections above ^^^ absolutely do not take a quinolone.

Read my edits up above.
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