Trio of antibiotics

[lmkmip67]

Dr. B put Ian on augmentin, azyth and bactrim. he took the first dose of all of it yesterday (pills, he can swallow them easily). He complained later in the day of feeling dizzy a little, and woke up last night with a headache. His stomach seems to feel ok (that was a concern). Now I am concerned he is having side effects from all of this? Dr. B is closed today, so not sure if I should stop them and just go back to the augmentin until I can talk to them or what. Thoughts? The headache kept him awake a couple of hours last night.

[LNN]

It is most likely a herx from infection die-off. When certain bacteria die (lyme, certain strains of strep which cause scarlet fever, others) they release toxins which can cause symptoms that are sometimes worse than the original infection. These die-off symptoms can last a week, several weeks or longer. I say it's likely herx because it's happened so soon after starting the trio. I think it would take longer for yeast to become an issue. But it can be very hard to tell the difference between 1. abx doing nothing and what you're seeing is just a continuation of original symptoms 2. a herx or 3. yeast or side effect from abx

 

It totally sucks. But for now, your best bet is to try to ride it out and read up on detox therapies. My son had to restart abx last week for his lyme. This week, he's had ice pick headaches and lots of muscle pain, and a wicked temper, extremely irritable and mean. Mortin helps but I need to give it on a regular basis. if I let too much time lapse, I lose the gains and have to start all over. He's also taking alpha lipoic acid, resveratrol and milk thistle (for the liver). A cold compress on the forehead helps at bedtime. We often see a return of old "Pandas" symptoms.

 

Herxing is unfortunately a part of treatment. It's a perverse sign that the abx are killing something. On the other hand, too severe a herx is a sign that the body is being overwhelmed with toxins and slowing down treatment can help reduce symptoms. When my son's tics returned during an aggressive treatment, we needed to back down on dose and frequency. So it's a balance between killing the stuff yet not triggering more than your family can handle.

 

If you don't see any serious reactions such as breathing problems or hives or heart racing, I'd personally push through and not retrun to the augmentin. Herxing is one of the major reasons we lyme moms get so annoying in pushing LLMDs. As a parent, it's really hard to navigate a herx. LLMDs can usually give you ideas and medical guidance to get you thru with less anxiety - still a rough time but with the assurance they've seen it all before and know how to lessen the impact of a herx without abandoning ship altogether.

[philamom]

I agree with LLM. You may want to try some lemon water and an epsom salt bath. Definitely have him drink extra water, if possible.

 

Also, are you giving him probiotics?

[momcap]

Something our LLMD told us to do to lessen herxing is to start with 1 antibiotic and wean up to the full dose over several days or even a couple of weeks if necessary. At the same time we supported the body with herbal detoxes. If herxing was minimal or manageable at that point then we added the next antibiotic and weaned up slowly, and then the next, etc. The overall treatment takes longer this way, but there is no way we could have thrown everything at DS at once and survived. I don't know if Dr. B would support this approach, but it has worked wonders for us.

[philamom]

Another good reason to work with an lyme literate doctor. There are times when you shouldn't work through a herx and back off with treatment, like LLM and momcap stated. After being off abx in fall/winter, it took my daughter 3 months to resume her Amoxicillin full strength. When trying to increase by 250mg increments, her LLMD advised us to stop if there were any signs of excessive herxing, and try again in a few weeks. She stayed at 500mg for a month. She was showing signs of distress/inflammation at the time. Also, she can no longer tolerate zith (another abx she was on) for treatment.

 

If the headaches continue to be excessive after a few days, you may want to call to inquire.

Edited August 17, 2012 by philamom

[SSS]

There is some brilliant advice here.

 

I just put my own dd back on a combo of antibiotics - we were off them completely for 2+ months- then hit a serious flair/regression-

 

This time, I did slowly and 1 at a time ease her up on them, over a couple of weeks (and am still under Dr.s prescription level of Amoxicillin, which is pretty darn high)

 

AND, have been really focusing on detox/trying to manage the die off with her-

 

Doubled her probiotics to 100 billion, and recently added a trio of homeopathic drainage remedies--also takes milk thistle, and some liquid herb detox stuff-

 

And she is evening out.

[JAG10]

Lisa,

Awhile back Dr B tried adding Bactirm to my dd12's abx for "possible Bart." I don't remember if it started right away, but she had some headaches and stomache aches yet NO behavioral changes-nothing. We had labs drawn 3 weeks later and her liver enzymes were crazy high; ALT and AST in the 700's and 300's when they should both be around 20!

 

We immediately stopped EVERYTHING. 6 weeks later her liver enzymes were down to 50's and 60's, no headaches or stomache aches. After that, her ALT and AST have always measured back in the low 20's despite the many other abx and supplements. Sooooo, in my girl's case, it was definitely the Bactrim. Lots of folks here have had great, great success with Bactrim. I think it's worth trying. And like I mentioned, her liver quickly recovered from its poor reaction to Bactrim. But, especially if these headaches persist, be sure to check his liver in 3-4 weeks, I wouldn't let it go much longer than that without running liver labs to be sure.

 

Best of luck!Jill

[lmkmip67]

Ok, all good to know, thank you, all!! I am backing off to starting with just two antibiotics for now. I have him back on the augmentin and gave him the azyth today. I wondered if it could be the Bactrim. so I think we will start slow like this for a few days. I will call on Monday and mention the headaches and tell them what I am doing. Or write to the nurses, rather. that seems to be the only way I hear back about anything. I am going to get a few things for him like the milk thistle, some epson salts and up his probiotics, I think. We will go from there. If it keeps on as bad as it was today, I will take it back down to just one and talk to Dr. B again. I did tell him I was only willing to try this for 6 weeks, when we go back, and see how it goes. If there is no positive change of any kind I do not want to keep him on numerous antibiotics. He does a bit better on just augmentin, so there is some benefit. The tics stay away. But I think we will be seeing the LLMD in a couple of months once we clear this experiment. Poor kids of ours, on so many medications and supplements.

[lmkmip67]

As of right now I have him on just two and he is doing ok. I also am doing probiotics and milk thistle. I have pretty much confirmed it is the Bactrim. I am going to get in touch with the office tomorrow, but will request that we stick to this for a week and then maybe try the Bactrim back in next week. If it causes headaches again we are going to have to find something else, or just stop it, because he starts school in a couple of weeks and I can't send him with the awful headaches. Motrin helps, but he says his head still feels "heavy."

[ptcgirl]

Bartonella seems to be back with my dd so llmd prescribed azith and bactrim in addition to the augmentin she was already on. A bit worried about adding in the bactrim. Seems like so many have bad experiences on it. Also concerned that llmd didn't mention liver stuff or to get her checked after being on it. I guess he was just going to do it at her next appt but that is three months away. Bartonella went away before but now it is back. I wonder if any of this will do any longterm good. It is reassuring that dr b is also using these meds. Makes me more comfortable with it. Will see him in sept so maybe will just wait. Anyone have a good response to bactrim???

[LNN]

Anyone have a good response to bactrim???

 

Both of my kids did really well with bactrim, even my DD who's allergic to most abx. Ironically, bactrim is one of the few abx she can take. It made a huge difference in my DS when we first started bartonella/lyme treatment.

[momcap]

Anyone have a good response to bactrim???

 

 

Yes and no.

 

All 3 of my boys took bactrim. The younger two (5 & 7) took it for lyme/bart along with several other meds. They did well on it. They are both off antibiotics now after 12 months. My oldest DS(8) took it for lyme/bart/PANDAS. He was a nightmare on it. We tried weaning up slowly. Then even more slowly. We took a pause and tried again. We doubled up our detox efforts. We stuck with it for about 6 months and were never able to wean up at all. Even at a tiny dose he would get very agitated. So eventually we decided this was a side effect and not a herx. We gave up on it and switched it out for rifampin - which gave him a horrendous herx and then the best improvement we had seen in a long time.

 

You never know until you try.

[ptcgirl]

Thanks for the info! I think we are going to go ahead and do it, but go really slowly with it (in case of reaction).