Antimicrobial
Anti=”against”
Microbial=”pertaining to a microbe or microorganism, especially a pathogenic one such as a bacterium, protozoan, or fungus”
Allopathic (or conventional) treatments for Lyme disease and its co-infections tend to be the most effective but can also have the most adverse effects. These include antibiotics, antifungals, and antiparasitic treatments (as broken up on this page).
There are many side effects that need to be understood and considered before beginning any of these treatments. It is important to have an in-depth conversation about all possible side effects with your treating physician. For myself, I found it was helpful to do my own research on it as well, just in case.
The idea of being on pharmaceutical medication for extended periods of time was not my ideal scenario as many people feel. However, in this case….with this disease, I feel it was the better choice for me. I also believe that using certain herbal remedies for Candida after treatment had some antimicrobial benefit, and continues to have an effect in after treatment maintenance. Some people are allergic to antibiotics or have sensitivities and may not have any other choice than to try alternative remedies. I have heard of overwhelmingly good results with a combination of both. It is a personal choice, and it is one that should be carefully considered and discussed with your doctor. Conventional or Alternative, make sure that whatever you take does not contain wheat, yeast, soy, dairy, alcohol, sugar (in any form) or any other allergens.
I am not going to go into details of what drug is best for Lyme disease or its co-infections as there are many differing opinions about this, not enough research, and it is not my business or my place to do so. That is what your doctor is for. Each person is going to be different, have different infections, and different reactions. I will, however, provide a basic description of antimicrobials, how they work, and give brief descriptions of the most commonly prescribed ones and some of the possible side effects.
If you are interested in learning more about a specific drug or drug interactions, please go to one of these two links:
Gluten Free Drugs
For Lyme specific treatment information, please reference Dr. Burrascano’s Guidelines.
Antibiotics
Anti=”against”
Biotics=”of or having to do with life or living organisms”
Antibiotics in their simplest and most common forms are created from molds and have been used in many cultures throughout history. There are many natural products that have antibacterial and antifungal properties which I describe in further detail on the Naturopathic Treatments page. In the 1920s Sir Alexander Fleming discovered Penicillin. It was around 1940-1950 that today’s common antibiotics were discovered and recognized as a viable medical treatment. They can be administered either orally or intravenously.
Although there are various types of antibiotics, they each work in one of two ways as described in “The History of Antibiotics“:
Bactericidal: “Kills the bacteria generally by either interfering with the formation of the bacterium’s cell wall or its cell contents.”
Bacteriostatic: “Stops bacteria from multiplying by interfering with bacterial protein production, DNA replication, or other aspects of bacterial cellular metabolism.”
Antibiotics are further classified as Narrow Spectrum (targeting specific types of bacteria) and Broad Spectrum (targeting a wide range of bacteria). The latter tends to be the most effective in Lyme treatment but does not distinguish between “good” bacteria and “bad” bacteria which are the main cause of Candida yeast overgrowth (see the Candida and Lyme page and the Antifungal section below). Broad Spectrum antibiotics also promote antibiotic resistance.
These are the basic families of antibiotics:
Aminoglycosides
Type: Bacteriostatic
Spectrum: Broad
Common Names: Streptomycin, Gentamicin, Tobramycin, Amikacin, Netilmicin
Description: Inhibits protein synthesis
Side Effects: Candida Fungal Overgrowth/Infections, may impair liver and kidney function, Ototoxicity (damage to the ear and hearing).
Cephalosporins
Type: Bactericidal
Spectrum: Broad
Common Names: Cephalexin, Cefazolin, Cefadroxil, Cephalothin, Cephapirine, Cephradine (there are four generation types of Cephalosporins)
Description: Inhibits Cell Wall Synthesis
Side Effects: Candida Fungal Overgrowth/Infections, diarrhea, nausea, mild stomach cramps or upset.
Fluoroquinolones
Type: Bacteriostatic
Spectrum: Broad
Common Names: Norfloxacin, Ciprofloxacin, Levofloxacin, Enoxacin, Ofloxacin
Description: (Synthetic) Inhibits DNA Synthesis and interferes with bacterial enzymes
Side Effects: Candida Fungal Overgrowth/Infections, nausea, vomiting, diarrhea, abdominal pain, (Rare: nervous system effects, phototoxicity, convulsions). May affect bone growth, not recommended for children or pregnant women.
Macrolides
Spectrum: Broad
Common Names: Erythromycin, Clarithromycin, Azithromycin
Description: Inhibits Protein Synthesis
Side Effects: Candida Fungal Overgrowth/Infections, nausea, vomiting, diarrhea (Rare: temporary auditory impairment; should be used with caution if liver dysfunction is present).
Penicillins
Type: Bactericidal
Spectrum: Narrow and Broad
Common Names: (Narrow) Pen G, Pen V, Nafcillin, Oxacillin, Dicloxacillin; (Broad) Amoxicillin, Ampicillin
Description: Inhibits Cell Wall Synthesis
Side Effects: Candida Fungal Overgrowth/Infections, diarrhea, nausea, vomiting, and upset stomach.
Tetracyclines
Type: Bacteriostatic
Spectrum: Broad
Common Names: Tetracycline, Doxycycline (Or Doryx-time release), Minocycline
Description: Inhibits Protein Synthesis, crosses blood/brain barrier
Side Effects: Candida Fungal Overgrowth/Infections, cramps or burning of the stomach, diarrhea, sore mouth or tongue, photosensitivity. (Rare: severe headache and vision problems may be signs of dangerous secondary intracranial hypertension; can be toxic over time; use of expired drugs can be dangerous).
Anti-Mycobacteria
Type: Bacteriostatic
Spectrum: Broad
Common Names: Rifampin, Streptomycin, Dapsone, Isoniazid, Ethambutol,
Description: Inhibits DNA Synthesis
Side Effects: Candida Fungal Overgrowth/Infections, fever, skin rash, toxicity.
Antifungals
Anti=”against”
Fungal=”of or caused by a fungus or fungi”
Antifungals are used to treat fungal infections. Unfortunately, since fungal cell membranes are similar to animals, antifungal medications can be potentially toxic to humans and close monitoring is necessary by a physician. Although there are topical antifungal medications (for things such as ringworm, athletes foot, and jock itch), I will only list internal antifungals here.
There are three main forms of internal fungal infections in humans, of which Candida is the most common:
Candida causes Candidiasis
Cryptococcus causes Cryptococcosis
Aspergillus causes Aspergillosis
For the Lyme and/or Candida patient, antifungal medication often becomes a necessity. It is important to understand that prevention with diet is the best option. If you already have Candida overgrowth, than you may need to take antifungal medication to get it under control. However, it is imperative that a strict anti-Candida diet is followed throughout Lyme or Candida treatment in order to be successful with both. For more information on Candida, please see the Candida and Lyme page. For details on the specific anti-fungals listed here, please go here.
Similar to antibiotics, antifungals work in two ways:
Fungicidal: Kills the fungi or yeast by either interfering with the formation of the cell wall or rupturing the cell wall.
Fungistatic: Prevents the fungi or yeast from multiplying by interfering with fungal growth, DNA or RNA synthesis, or cellular metabolism.
These are the basic families of antifungals:
Azoles: Triazoles and Imidazoles
Type: Fungicidal and Fungistatic
Spectrum: Broad
Common Names: Tirazoles (Fluconozole, Diflucan, Voriconazole, Itraconazole, Vfend, Sporanox); Imadazoles (Ketoconazole, Clotrimazole, Miconazole) For details on how each of these works, please go here.
Description: Interfere with fungal growth and ability to build cell walls.
Side Effects: Hepatotoxicity (liver toxicity), and endocrine toxicity. Liver function must be monitored regularly (monthly or bi-monthly). Other signs of liver toxicity are itchy skin, abdominal cramps, dark urine or stool, and pain at the base of ribs.
Note: Some believe that Fluconozole can treat Lyme disease, but there is no evidence proving this. It is theorized that it helps to prevent Lyme from reproducing, but it does not kill Lyme spirochetes. Fluconazole is considered to be well-tolerated and the treatment of choice for Candida, however. It targets Candida and Cryptococcus, penetrates into tissues, and effectively crosses the blood-brain barrier to reach fungus and yeast that has affected the central nervous system. Candida can build up resistance to this drug and should not be relied upon long term.
Flucytosine
Type: Fungistatic
Spectrum: Broad
Common Names: Flucytosine, Ancobon
Description: Interferes with DNA and RNA synthesis. Soluble in water. Develops resistance to fungi and yeasts easily, so is usually used in combination therapy with an Azole or Polyene.
Side Effects: Vary depending on combination therapy. Renal problems can be an issue and can cause bone marrow depression. GI disturbances, hepatoxicity, Central Nervous System Toxicity.
Polyenes
Spectrum: Broad
Common Names: Amphotericin B, Nystatin
Description: Ruptures the cell wall. Not absorbed from the GI tract, so are not effective against hyphae or systemic fungal infections unless taken intravenously. When taken orally, they can be effective against oral thrush and Candida that exists within the GI tract.
Side Effects: When administered via IV, these are highly toxic to the liver and must be monitored closely. Orally, they are relatively safe since they are not absorbed systemically.
Caspofungin (Cancidas)
Type: Fungicidal and Fungistatic
Spectrum: Narrow
Common Names: Caspofungin
Description: Inhibits hyphae growth. Administered via IV and is generally used for invasive Aspergillosis infections that are not responding to other treatments. Fungistatic against invasive Aspergillosis and Fungicidal against invasive Candida. Is not currently licensed for use for Candida. Does not affect Cryptococcus.
Side Effects: Minimal
Terbinafine(Lamisil)
Type: Fungistatic
Spectrum: Narrow
Common Names: Terbinafine
Description: Inhibits the growth of fungi. Typically used for dermatological infections (skin, nails, and fatty tissues.)
Side Effects: Mild GI effects
Antiparasitics
Anti=”against”
Parasitic=”of or caused by a parasite”
Antiparasitic treatments vary depending on the type of infestation. There are three main families of parasites: Protozoans (single-celled), Helminthics (multi-celled or worm-like), and Ectoparasites (arthropods such as lice, fleas, mites, ticks, etc…). I will not address Ectoparasitic medications here as they are generally topical.
Many Lyme patients also suffer from co-infections including parasitic infections. Treatment often includes drugs that are both antibacterial and antiparasitic for this reason. It is important with parasitic infections to determine which parasite is present. There are very specific drugs that are used depending on which parasite is being treated.
Although conventional medications may be needed for severe parasitic infestations, there are many herbal cleanses that are effective with parasites. In particular, doing a parasite/colon cleanse once or twice a year is good for preventative maintenance. See the Naturopathic Treatments page and the Heavy Metals & Parasites page for more information.
These are the basic families of antiparasitics:
Anthelmintic
Type: Helmintic-cidal.
Spectrum: Broad/Narrow
Common Names: Abamectin, Albendazole, Mebendazole, Niclosamide, Ivermectin, Praziquantel, Pentamidine, Metronidazole, Thiabendazole, Triclabendazole
Description: Treats a variety of parasitic worm infections caused by specific worm-like parasites such as Nematodes, Cestodes, and Trematodes. Drug action varies.
Side Effects: Varies depending on drug. Can cause liver toxicity, cardiotoxicity, dizziness, nausea, vomiting, diarrhea.
Antiprotozoal
Type: Protozoan-cidal, bactericidal.
Spectrum: Broad/Narrow
Common Names: Metronidazole (Flagyl), eflornithine, furazolidone, hydroychloroquine, iodoquinol, and pentamidine.
Description: Treats a variety of protozoan infections caused by specific protozoal parasites such as Trichomonas and malaria-like organisms. Drug action varies.
Side Effects: Varies depending on drug. Can cause liver toxicity, cardiotoxicity, dizziness, nausea, vomiting, diarrhea, fever, chills, blood in urine or stools, skin rash, numbness, blurred vision.
Antiamoebic
Spectrum: Broad/Narrow
Common Names: Luminal: Paromomycin, Erythromycin, Tetracycline, Iodoquinol; Tissue: Nitromidazole, Dehydroemetine
Description: Effective against specific amoebic parasites (a specific type of Protozoan). Luminal (localized intestinal), direct (affect amoeba organisms directly), indirect (affect intestinal flora making it less friendly for ameobas), and tissue (affect amoeba cells in the tissues of the host). Drug action varies.
Side Effects: Varies depending on drug. Can cause liver toxicity, cardiotoxicity, dizziness, nausea, vomiting, diarrhea.
Allopathic Medicine has its benefits…
And its limitations.