What's best treatment for strep and Lyme positive combo

[Pandasphilly]

This post is mainly about treating resistant strep with now a lyme diagnosis. I'm sorry if I belong on the lyme board but the treatment resistant strep is my main concern.

 

DS10 FINALLY came up positive for Lyme after testing 3-4 times over the past year. At the same time he is positive for strep with titers climbing from 400 to 800 over the year on treatment of high dose Augmentin XR1000 & intermittent Clindamycin & azithromycin (to which I saw no improvement but who knows).

 

He has Lyme Reactive bands 23 & 41.

 

What is the best antibiotic (or combo) to treat both resistant strep and lyme? Dr. L wants to change out Augmentin XR with Clindamycin but I saw no previous improvement.

 

Any suggestions? Any success stories? Rifampin? other?

[LNN]

We've been on many combos - generally you want at least one intracellular and one extracellular abx. When we first started with our LLMD, my son was on augmentin + zith (which was doing nothing) and he didn't want to change too much at once (or you don't know what's responsible for any change you see). So he added bactrim (for suspected bartonella). Saw nice improvement that first month. We stayed on that for 4 months. Then we dropped augmentin and a few weeks later added omincef (so zith+bactrim+omnicef). Holy cow - what a herx.

Most recently, we've been on a zith+rifampin combo that's worked very well.

 

You're probably going to want to keep zith on board for the intracellular piece even if zith hasn't been your "wow" abx. Rifampin, bactrim and omnicef were the additions that made the most difference for my son. But if you feel Lyme and/or coinfections is part of your picture, you may want to consider adding an LLMD to the team. Love dr L but she isn't going to have the experience for Lyme and co. (I assume you've done a T&A?)

[Pandasphilly]

We've been on many combos - generally you want at least one intracellular and one extracellular abx. When we first started with our LLMD, my son was on augmentin + zith (which was doing nothing) and he didn't want to change too much at once (or you don't know what's responsible for any change you see). So he added bactrim (for suspected bartonella). Saw nice improvement that first month. We stayed on that for 4 months. Then we dropped augmentin and a few weeks later added omincef (so zith+bactrim+omnicef). Holy cow - what a herx.

Most recently, we've been on a zith+rifampin combo that's worked very well.

 

You're probably going to want to keep zith on board for the intracellular piece even if zith hasn't been your "wow" abx. Rifampin, bactrim and omnicef were the additions that made the most difference for my son. But if you feel Lyme and/or coinfections is part of your picture, you may want to consider adding an LLMD to the team. Love dr L but she isn't going to have the experience for Lyme and co. (I assume you've done a T&A?)

[Pandasphilly]

Thanks LLM. You are a guiding light on this forum and I really appreciate your quick reply. We added Cipro a few weeks back due to urinary problems (which all of us pandas moms know are not bladder infections but what the hec I was hoping) and we did see some small improvement in mood, behavior etc. It was big enough for my husband to notice so maybe it wasn't all that small. Is Cipro along the lines of bactrim? Maybe I can convince Dr. L to consider your regime as repeating the same failed approach doesn't make sense to me.

[LNN]

We never used Cipro. I just did a very quick google and found this http://www.wellness.com/news/7962/lyme-disease-testing-not-the-way-to-diagnosis/health-and-wellness-news which says cipro is not good for lyme. However, I should be clear that we didn't use bactrim for lyme. We used it for suspected bartonella.

 

You may want to pop over to the lyme forum and ask for additional opinions and on LLMD recommendations. In the meantime, I'd probably try to see if she'd consider zith+rifampin or zith+omnicef. Not because they're "the best" but because they're probably most familiar to her and she may be more comfortable with those. (Omnicef crosses the BBB - read up on detox and anti-inflammatory ideas. herxing sucks).

[beeskneesmommy]

For us, it has been the combo of Augmentin and Azith, although my son is younger - began the combo at age 4.5 to the present, age 6. I believe, if memory serves me, that Azith is the best choice for Lyme/Myco for littler kids...

[KAD]

LLM, as we begin treatment for bartonella for my son 16, can you tell me when you say herxing sucks, how long does it usually last and is it a worsening of existing symptoms (OCD, verbal tics, extreme anxiety, rage, etc.) or something different and what have you found to be the most effective combatant to herxing. There are so many suggestions - epsom salt baths, saunas, supplements, etc. It just scares me to think it can get worse before getting better and putting a timeframe to it would make it more bearable. Thanks.

[Ebersolk]

My daughter had Lyme, Ehrlichia and Bartonella.

 

 

Before the lyme diagnosis we had been on many antibiotics for PANDAS/Pans but had been at that time on 300 omnicef. My daughter is allergic to penicillin. Lyme doctor added azith and minocycline. Minocycline caused her to have issues w/her teeth ( any cycline antibiotic can give you issues w/discoloring of teeth and gums especially if you do not have permanent teeth it may be an issue) so we switched out to bactrim. Recently we added in tindamax so she is on omnicef, azith, bactrim and tindamx only on the weekends. Our last blood draw showed no more ehrlichia or bartonella and the bands are going down for the lyme however I have noticed increased strep antibodies. Not sure if from exposure or from treating the lyme. At one point we were down to 60 from greater than 1,360 but now are back up to over 400.