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Drug of Choice for Bartonella?


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12 replies to this topic

#1 911rn

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Posted 24 February 2012 - 01:56 PM

Hello Lyme Mamas and Dads,

I wrote once before thinking my neurotypical son may have been exposed to Bartonella, in last year, based on waxing and waning stretch mark- like rashes on his arms, chest and groin over the last year. I have watched it long enough- comes and goes, fades and returns very ropey and dark. I think he has it. Planning to take him to Peds----they can do titers or whatever they want to do or just treat him with round of antibiotics. He is asymptomatic as far as I can tell of other symptoms- just the rash that seem to be following a tick borne illness cycling.

Upon researching- seems like Levaquin is the drug of choice for treatment not Doxy as I had surmised.

Questions: What are Lyme forum folks being treated with for Bartonella??? I have read a month or two of antibiotics may be necessary? Does this sound right? As I have said- NT, no issues, good student, good grades, no other issues other than rash---stretch marks? He is not overweight. He is my outdoorsy kid and he/I have pulled more ticks off him over the years than I care to mention.

Thanks, in advance, for any replies.


#2 lyme_mom

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Posted 24 February 2012 - 02:27 PM

Rifampin is what we were treated w and it takes 5 or 6onths at least. I'd want to do energetic testing to see if it's bartonella before treating because he has no other symptoms.

#3 momcap

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Posted 24 February 2012 - 05:10 PM

We were treating with bactrim, but it was not well tolerated (mood s/e), so we recently switched to Rifampin. It's too early to say, but I already think it's doing its job. It's only been a week and he's noticeably calmer and happier. My boys are playing together happily for hours at a time, something that never happened before. He is having more physical symptoms though - tingling in the hands and feet, mild diarrhea, sore soles, joint pains (nothing new, but sx we haven't seen in a while). So I guess we'll see how it goes.
DS9 - Lyme & PANDAS (IgM & IgG positive on lyme Western Blot, chronic elevated ASO in 300-500s with baseline ASO of 27 before scarlet fever, CamK II @ 176, and anti-dopamine 1 @ 4000)
DS7 - Lyme (IgG positive) & "strep carrier"
DS6 - lyme (IgG positive) & chronic elevated ASO in 500-700s

#4 bill

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Posted 24 February 2012 - 05:17 PM

Our doctor has stayed with azithromycin and minocycline to treat both the lyme bacteria and bartonella.

Up until last week, we also added tindamax on the weekend; just switched to flagyl. Believe that's just for the lyme bacteria though.

Son, Age 14, Lyme/Bartonella/Pandas
Started treatment October 2010
ABX, 6 IVIGs to date.
Making progress.

#5 rowingmom

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Posted 24 February 2012 - 07:10 PM

Our LLMD Rx rifampin/biaxin which has been working wonders for pain and motor/vocal ticcing. We tried switching to biaxin/plaquenil after 3 months, but all the bartonella symptoms had reappeared after another 3 months. Back to biaxin/rifampin and in 3 weeks all symptoms have resolved again. Rifampin seems to be the key for us.

DD12 - Born 2001. Loss of speech/fine motor ability 2 weeks after 15 month MMR vaccination.
2004 - Dx ADHD, sensory disorder (light, sound, touch), motor delay (with toe-walking), hypotonia, oral apraxia.
2008 - MMR booster and insect bite (bruise-like rash) - motor/vocal tics, emotional lability (including rage), age regressive behaviour, low level OCD, urinary frequency, diminished fine motor ability, insomnia, loss of executive function. Waxed and waned with strep/viral infections.
2010 - Dx ADHD, Tourettes, Aspergers, motor delay, probable PANDAS.
Jan 2011 - shin/forearm pain, cyclic IBS, foot (sole) pain, dizziness, palpitations, chest pain, anxiety/panic attacks, pick-like skull pain, pain and stiffness at base of skull, tingling in extremeties, chills and hot flashes, extreme fatigue, nightly fever. 
June 2011 - Igenex PCR positive bartonella, Negative ELISA, Negative lyme (IND IgM kDa 41; IND IgG kDa 39, 34.  kDa 41++). CD57 18.  Positive ANA (speckled type), heterozygous A1298C MTHFR. Multiple Abx, methyl B12, methylfolate, P-5-P, herbal, homeopathic treatment with LLMD.

Jan 2013 - Bartonella IgG titers declined from 160 (Jun 2011) to 80.  CD57 16. 

April 2013 - Weaned from abx treatment.  Continue with Buhner herbs, Terry Wahls/PerfectHealthDiet gf/cf/sf diet.  Minimizing EMF exposure.

Sept 2013 - CD57 45.  

Oct 2013 - All symptoms (PANS and pain/fatigue) 95% resolved.  No flares with viral or other infections.  Herxing remains with changes in herbal protocols.

Nov 2013 - Improvement to 98% with addition of herbal protozoan treatment.

Dec 2013 - ANA titers negative.  PANS symptoms resolved.  Regular classroom requiring no accommodations.  B+/A student.

Mar 2014 - Continued improvement in cognitive/executive function with increased dosages of cryptolepis/sida/alchornea tincture.         

DS17 - Born 1996. No unusual symptoms.


#6 michaeltampa

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Posted 24 February 2012 - 08:04 PM

Levaquin is a 3rd generation fluoroquinolone. I was treated for bartonella with gemifloxacin (a 4th generation fluoroquinolone) directly targeting the bartonella, but taken along with tindamax and telithromycin targeting the borrelia, and, for a period of time, also with clindamycin to get the babesia. If one can tolerate it, one can be more successful targeting all the coinfections/infections at once rather than trying to go at it one at a time.

#7 sss

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Posted 25 February 2012 - 04:15 AM

Levaquin is a 3rd generation fluoroquinolone. I was treated for bartonella with gemifloxacin (a 4th generation fluoroquinolone) directly targeting the bartonella, but taken along with tindamax and telithromycin targeting the borrelia, and, for a period of time, also with clindamycin to get the babesia. If one can tolerate it, one can be more successful targeting all the coinfections/infections at once rather than trying to go at it one at a time.



Because I had a positive bartonella test out the gate, our Dr. had given me Levaquin (by itself) for 6 weeks- it was a doozy, but hit bartonella for sure.
Since then, I did 4 weeks of Rifampin, was feeling great about 2 weeks into it, a deep relaxation in my mind I hadn't felt in I don't know how long.
Got pulled off it. Lost the gains I had been feeling.
Weeks later, put back on Rifampin- it's been a week and a half back on, and I am herxing horribly-probably the worst week I've had-
BUT- it feels and all the symptoms flaring now are babseia, which I have never treated.

We are seeing a new Lyme Dr. on Tuesday and making a switch.
All of this back and forth isn't working for me (us.)

So, I guess if bartonella is a standalone Lyme infection, which I am not sure is possible, any of the standard bartonella antibiotics will hit it, but if there are other infections there, too- well, it's bloody complicated and you can stir up some serious stuff- which is why it's very important to have a knowledgeable Dr.
Daughter 9, PANS, probable congenital Lyme,
started biomedical treatments w/DAN! and GF/CF at age 4
Cam K 175, 2 HD IVIG's, 2 LLMD's- had improved, but still challenging in areas at times.
Mom-tested positive Igenex PCR Lyme, and positive Bartonella, 2011.
After long tx break for dd9, where we backslid, in Spring '14 decided to resume tx for Lyme and co-infections,
with LLMD, and finally saw a PANDAS specialist (amazing experience and person)
and as a result, have a wonderful new baseline! (everything crossed!)

#8 mdmom

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Posted 25 February 2012 - 05:03 AM

Our LLMD treats Bartonella with a pulsing therapy of 21 days of Rifampin Mon-Fri, Azithromycin Sat-Sun. then we break from this and do 7 days of Flagyl. And repeat the whole thing for I'm not sure how many months, as we are into month 4.

DS16 dx with PANDAS/Lyme & Co. at age 13 symptomatic since age 2; originally dx with Asperger's, OCD, Anxiety, PTSD
DD14 dx with Lyme, Babesia, Bartonella at age 11, symptomatic from birth

Mom & Dad with various symptoms for 20 years; both M & D being treated for Lyme & Co.

Also addressing MTHFR, diet (GF/CF/GMO-free or Organic),


#9 911rn

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Posted 25 February 2012 - 10:48 AM

WOW!!!! Thanks for all the replies. Seems like everyone is doing something a little different- no standard protocol. I am not highly suspicious for LYME- no symptoms. Although, I understand that bartonella is seldom a stand alone infection and one must consider it to be a co infection. I think I may just ask Peds for titer testing for both and see what happens. I'm thinking that since the only symptom he seems to have is rash- he may respond well to conventional therapy- 1 to 2 antibiotic cocktail for reasonable amount of time?

Thanks for ALL!

#10 michaeltampa

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Posted 25 February 2012 - 01:58 PM

Bartonella is a.k.a. cat scratch fever, so perhaps it can be standalone for cats, but, agree, don't here too much about it being standalone for humans.

#11 rnmom

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Posted 26 February 2012 - 10:50 AM

Bartonella can be a "stand alone" infection but it is a common Lyme co-infection. There are a couple of difficult issues to deal with whne treating Bartonella.:
1) The antibiotics that treat Bartonella do not address Lyme or the other co-infections.
2) You must be on the antibiotics for Bartonella for at least 6 months to a year. some people need even longer.
3). Rifampin is one of the best drugs for Bartonella but it must be combined with another antibiotic such as Azithromycin, Bactrim, or Cipro. the reason for this is that Bartonella very quickly develops resistance to Rifampin if given alone. (There is a lot of literature about this regarding the use of Rifampin to treat TB.)
4). Starting and stopping (and/or restarting) Rifampin is not the best practice. I know it is common to "pulse" Rifampin. However, the medical literature frequently states that "flu-like symptoms" often occur when the Rifampin is restarted (who knows if this is actually a Bartonella Herxheimer in an undiagnosed patient rather than "flu-like symptoms.") Allergic reactions to Rifampin are also more likely when pulsing this antibiotic. Most of all the risk of developing a Rifampin resistant strain is the biggest reason not to stop and start this particular antibiotic.
5) Overall, due to the rapid replication of the Bartonella organism (days)it is easy to fall back to square one in the treatment process when the Bartonella treatment is put on pause.

#12 911rn

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Posted 26 February 2012 - 04:43 PM

Bartonella can be a "stand alone" infection but it is a common Lyme co-infection. There are a couple of difficult issues to deal with whne treating Bartonella.:
1) The antibiotics that treat Bartonella do not address Lyme or the other co-infections.
2) You must be on the antibiotics for Bartonella for at least 6 months to a year. some people need even longer.
3). Rifampin is one of the best drugs for Bartonella but it must be combined with another antibiotic such as Azithromycin, Bactrim, or Cipro. the reason for this is that Bartonella very quickly develops resistance to Rifampin if given alone. (There is a lot of literature about this regarding the use of Rifampin to treat TB.)
4). Starting and stopping (and/or restarting) Rifampin is not the best practice. I know it is common to "pulse" Rifampin. However, the medical literature frequently states that "flu-like symptoms" often occur when the Rifampin is restarted (who knows if this is actually a Bartonella Herxheimer in an undiagnosed patient rather than "flu-like symptoms.") Allergic reactions to Rifampin are also more likely when pulsing this antibiotic. Most of all the risk of developing a Rifampin resistant strain is the biggest reason not to stop and start this particular antibiotic.
5) Overall, due to the rapid replication of the Bartonella organism (days)it is easy to fall back to square one in the treatment process when the Bartonella treatment is put on pause.


Great info...thanks for sharing. I'll keep all this in mind. I'm going to schedule appt with Peds and see where to go from here.Batonella, lyme titers etc.

#13 MamaOnAMission

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Posted 27 February 2012 - 02:01 PM

So bactrim and minocycline are not addressing my child's Lyme, it's only dealing with her battonella?
I'm surprised since I'm going to top LLMD and was not it told this.

Edited by Lilly, 02 October 2012 - 10:39 PM.





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