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Pulsed-dosing (i.e., antibiotic therapy on some days but not on other days)

First-generation cephalosporins, benzathine penicillin G, fluoroquinolones, carbapenems, vancomycin, metronidazole, tinidazole, trimethoprim-sulfamethoxazole, amantadine, ketolides, isoniazid, or fluconazole.

Empirical antibabesiosis therapy in the absence of documentation of active babesiosis

Anti-Bartonella therapies

Hyperbaric oxygen therapy

Fever therapy (with or without malaria induction)

Intravenous immunoglobulin



Intravenous hydrogen peroxide

Vitamins or nutritional managements

Magnesium or bismuth injections

Potential Benefits of Treatment.  Some clinical studies support longer term treatment approaches, while others do not.  The experience in this office is that although most patients improve with continued treatment, some do not.

Risks of treatment.  There are potential risks involved in using any treatment, just as there are in foregoing treatment entirely. Some of the problems with antibiotics may include (a) allergic reactions, which may manifest as rashes, swelling, and difficulty with breathing, (b) stomach or bowel upset, or (c) yeast infections. Severe allergic reactions may require emergency treatments, while other problems may require suspension of treatment, or adjustment of medication. Other problems such as adverse effects on liver, kidneys, gallbladder, or other organs may occur.

Factors to consider in my decision.  No one knows the optimal treatment of symptoms that persist after a patient is diagnosed with Lyme disease and treated with a simple short course of antibiotic therapy.

The appropriate treatment may be supportive therapy without the administration of any additional antibiotics.  Or, the appropriate treatment might be additional antibiotic therapy.  If additional antibiotic therapy is warranted, no one knows for certain exactly how long to give the additional therapy.  By taking antibiotics for longer periods of time, I place myself at greater risk of developing side effects.  By stopping antibiotic treatment, I place myself at greater risk that a potentially serious infection will progress. Antibiotics are the only form of treatment shown to be effective for Lyme disease, but not all patients respond to antibiotic therapy.  There is no currently available diagnostic test that can demonstrate the eradication of the Lyme bacteria from my body.  Other forms of treatment designed to strengthen my immune system also may be important.  Some forms of treatment are only intended to make me more

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