I did fine taking minocycline for bartonella. However, minocycline will only kill active bacteria. You've got to take something to get bartonella out of its dormant state. I've had success with valproate, disulfiram, and atovaquone. Unlike borrelia, when dormant bartonella is disturbed, it tends not to die but just reactivates and goes into the red blood cells.
I'm assuming that's why you're taking diflucan. It's not really clear to me why diflucan would work against bartonella. It's an inhibitor of ergosterol synthesis, but it's not clear that bartonella has similar enzymes that could be inhibited by fluconazole.
If you can't take bactrim, you could possibly try a different anti-folate, such as proguanil or dapsone, but these drugs can be hard to tolerate too.
I tolerated Malarone (atovaquone/proguanil) easier than almost any drug when treating for Babesia. When I took Malarone with doxy/Zith for Bart this fall, the combo really only seemed to make the Bart worse and I eventually crashed. It made taking something as simple as doxy too tough for me and It also set off the POTS that has not relented since.
My doc is friends with Dr SP in CT and he uses Diflucan plus tetra 2 weeks on/off as his base treatment and used it on himself to cure his Bart (he had to shut his practice for a while bc of it, unclear if he took other drugs besides those). The azole drugs appear to have some effect on Bart for many people and I can tell you within 2 weeks I went from the worst I’ve been back to 95% using that combo. I had 2-3 months of feeling fantastic but Unfortunately Its magic seems to be running out.
There is a published in vitro study that shows many of the azoles having superior killing ability of Bart Hensellae, especially when combined with a tetracycline.
I am going to ask if I can substitute Mino for tetra since it has better BBB penetration as one of my next treatment options if he doesn’t want to do Cipro. Diflucan is easy and safe to tolerate for me still. I’m a little skittish about
DSF but I’ll do it if necessary. I’m still awaiting bloodwork from Igenix (only lab that has picked up the Bart, I’ve had 4 straight positive tests) and MDL. I’m holding out hope that maybe it’s just an autoimmune response but I doubt it. After I crashed off Mino/rifampin in 2018 after 8 weeks I switched to Bicillin Shots (since they seem to really help brain symptoms ) and was 100% after a few weeks. If I still test positive via Igenix then I have to decide with my LLMD if it’s cipro time or some other drug.