Most Lyme literate doctors do not prescribe long term antibiotics. Its a myth. Most Lyme patients get an initial dose of antibiotics 6 weeks in duration. For many that is enough. It is wait and see if the symptoms return. Some have a relapse in symptoms or continue to test positive for the disease. So doctors treat again with another 6 weeks of antibiotics. But this "on again; off again" treatment begins to have all the same data points as - "non compliance". Non compliance is the culprit in most antibiotic resistant infections caused by humans. To be responsible the Lyme doctor eliminates that "off" part of the on again, off again cycle. But only when needed and only for as long as it takes to establish that there is no more "die off" of the bacteria occurring. Like many bacteria Lyme has the ability to make a cyst and create a bio-film. Once in that state it is unlikely that any amount of antibiotics will eliminate it. So the Lyme doctor has a choice: remove antibiotics or continue as they wait for the infection to come out of its shell once again. Some are choosing to stop and wait and see. Others are choosing to continue on. To date not enough is known about late diagnosis treatments or treatment failures to determine the correct course of action.
However I personally find long term IV treatment worrisome. Simply put this is an extremely rare medical practice.
I volunteer regularly for hospice. I see people who have been on continuous IV antibiotics. Most are at the end of life. Most of this from "hospital illnesses" such as urinary track infection for patients who use a catheter or diaper (that the patient does not change themselves), or MRSA or poor GI performance. My point is these people are sick with something that occurs at end of life when they end up in the hospital. Not in the treatment of infectious disease. Even with TB and Syphilis the preferred treatment is oral. If IV is used it is for 6 weeks at the most. I don't usually see 2 years of antibiotic IV therapy with the treatment of an illness contracted out side of the hospital. 2 years of IV therapy is a long time even for Syphilis. It is just really worrisome.
Monday, July 13, 2009
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