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

[ILLUSTRATION OMITTED]

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