Diagnosis and therapy of chronic systemic co-infections in Lyme disease and other tick-borne infectious diseases

Townsend Letter for Doctors and Patients,  April, 2007  by Garth L. Nicolson

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Professor Garth L. Nicolson is the President, Chief Scientific Officer and Research Professor at the Institute for Molecular Medicine in Huntington Beach, California. Born in 1943 in Los Angeles, Dr. Nicolson received his BS in Chemistry from University of California at Los Angeles in 1965 and his PhD in Biochemistry and Cell Biology from the University of California at San Diego in 1970. He is currently Professor of Integrative Medicine at Capitol University of Integrative Medicine and a Conjoint Professor at the University of Newcastle (Australia). He was formally the David Bruton Jr. Chair in Cancer Research and Professor and Chairman of the Department of Tumor Biology at the University of Texas M. D. Anderson Cancer Center in Houston, and he was Professor of Internal Medicine and Professor of Pathology and Laboratory Medicine at the University of Texas Medical School at Houston. He was also Professor of Comparative Pathology at Texas A & M University. Professor Nicolson has published over 580 medical and scientific papers (including three Current Contents Citation Classics), edited 14 books and served on the Editorial Boards of 20 medical and scientific journals. Professor Nicolson has won many awards, such as the Burroughs Wellcome Medal of the Royal Society of Medicine (United Kingdom), Stephen Paget Award of the Metastasis Research Society, the US National Cancer Institute Outstanding Investigator Award, and the Innovative Medicine Award of Canada. He is also a Colonel (Honorary) of the US Army Special Forces and a US Navy SEAL (Honorary) for his work on Armed Forces and veterans' illnesses.

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Table 1. Treatment of Lyme Disease During the Different Stages of the
Disease (12,13)

Clinical Stage      Time       Primary Treatment  Alternative Treatment

Early localized     3-30 days  doxycycline        erythromycin
                               amoxcillin         clarithromycin
                               cefuroxime axetil  azithromycin
Early disseminated  1-12 wks   doxycycline        erythromycin
                               amoxcillin         clarithromycin
                               cefuroxime axetil  azithromycin
with CNS                       ceftriaxone (iv)   penicillin G (iv)
  involvement                                     doxycycline (iv or po)
Late disseminated   >2 months
with arthritis                 amoxcillin         penicillin G (iv)
                               doxycycline        doxycycline (iv or po)
with CNS                       ceftriaxone (iv)   penicillin G (iv)
  involvement                                     doxycycline (iv or po)
with cardiac                   ceftriaxone (iv)
  involvement                  amoxcillin

Table 2. Combination Treatments for Lyme Borrelia Plus Co-
Infections (17)

                             Mycoplasma/
Lyme Borrelia                Ehrlichia       Bartonella  Babesia

Amox+Probenecid+             +Doxycycline    +Septra     +Mepron
  Macrolide+Plaquenil                                    +Malarone
  [+ or -]Flagyl/Tinidazole                              +Lariam
Bicillin+Macrolide+          +Doxycycline    +Septra     +Mepron
  Plaquenil                                              +Malarone
  [+ or -]Flagyl/Tinidazole                              +Artemesia
                                                         +Lariam
Cephalosporin (po/iv)+       +Doxycycline    +Septra     +Mepron
  Macrolide+Plaquenil                                    +Malarone
  [+ or -]Flagyl/Tinidazole                              +Artemesia
                                                         +Lariam
Doxycycline+                 +Ciprofloxacin  +Septra     +Lariam
  Plaquenil                                  +Rifampin   +Malarone
  [+ or -]Flagyl/Tinidazole                              +Artemesia
Macrolide+Plaquenil          +Doxycycline    +Septra     +Mepron
  [+ or -]Flagyl/Tinidazole                  +Quinolone  +Malarone
                                                         +Artemesia
                                                         +Lariam

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