resistance when using 2 or more antibiotics is rare in bart - a few days without one or other is v unlikely to cause it.
they can cause true resistance to develop in bartonella in lab experiments - but it requires very specific conditions and many generations to achieve it.
so sounds more likely to me that something else is going on - poss even a flare due to the anti-fungals - terbinafine is known to cause immune system issues - acc to the drugs monograph - so perhaps that has just caused a flare of some sort
we do hear anecdotal accounts where people feel strongly that one or other abx stopped working for them - but in reality even though people may strongly believe this and i would not wish to offend them - its really very hard to know for sure whether this is what has actually happened - or if there is some other explanation - unless an isolate is cultured and tested - which almost never happens in Bart -
so we just don't know - but since its known that bart can cause a relapsing remitting type illness - there could definitely be something else going on.
some organisms do also loose resistance over time once the evolutionary pressure to develop it is removed - this applies to some gut bacteria for instance - however this feature tends to be a case by case basis for each species
Thank you. I read some studies where it took 3 passages of rifampin (using one small rifampin dose applied to a Bart culture, then waiting 2 weeks and then using another small dose), 4 passages of erythromycin and 5 of ciprofloxacin to achieve in vitro resistance. It's not clear if the same is applicable to humans, because bartonella aren't distributed equally in all human body parts, Bart mainly lives in tissues (?) If I understand correctly, studies show that it's difficult to isolate it from blood apparently. If it indeed lives in tissues and most abx have a hard time penetrating tissues, then to what extent is resistance achievable, I guess this question can't be answered yet. More human research would be needed. Also, humans having an immune system probably prevents relatively or at least makes it more difficult for the Bart bacterias to achieve the same level of resistance as in vitro, I would hope so.
Terbinafine caused me some severe itching all over without rashes, turns out this drug causes liver cholestasis and if taken long term could cause liver failure. I got so itchy I had to completely stop, I couldn't calm down from all the itch. It could be that bilirubin started leaking in blood and that was making me very itchy. Anyway, after I stopped taking it the itch went away. But the Candida isn't controlled without it, so I'll have to take it eventually.