https://www.treatlyme.net/guide/kills-bartonella-a-brief-guide

Comment; Lyme is such a difficult disease–typical of spirochetes, causing so much harm. Dr. Ross provides a great overview, stepwise approach.

In my experience, recovering from Bartonella, one of the Lyme disease co-infections, requires

• combination herbal or prescription antibiotics,
• steps to boost the immune system, and
• supplements to decrease inflammation caused by chemicals called cytokines.
Limited research shows which antimicrobials work best for Bartonella. Existing studies are petri
dish experiments showing intracellular antibiotics (ones that get inside of cells) work best.
Hence, the antibiotic treatments I describe below use these intracellular antibiotics.
Unfortunately, no studies about Bartonella treatment exist in people living with Lyme. As a
result, most experienced Lyme Literate Medical Doctors use their clinical judgment to determine
that it can take four to six months of continuous antimicrobials for Bartonella to resolve.
In my clinical practice, many different combinations of herbal and prescription antibiotics work
to cure Bartonella. I explain these various combinations below. With these treatments—
including steps to boost the immune system and to decrease inflammation—it is possible to cure
Bartonella 95 percent of the time, in my experience. This means five percent of people may have
relapses or require treatments involving a number of the different approaches below.

Boost the Immune System to Cure Bartonella
It is critical for Bartonella recovery to take steps that boost the immune system. Boost the
immune system following the first ten steps in The Ross Lyme Support Protocol. These steps
may
• correct sleep,
• decrease inflammation cytokines,
• help the immune system adapt to stress,
• correct hormone imbalances,
• provide essential micronutrients, and
• remove yeast overgrowth in the intestines if present.
Use Combination Antibiotics to Cure Bartonella
Bartonella can be difficult to treat when a person has a Borrelia (Lyme) infection. To prevent
relapse, it is best to use two antibiotic combinations. There are three tiers of treatments. Tier One
and Two include prescription antibiotics; Tier Three is an herbal antimicrobial combination. The
most effective treatments are in Tier One followed by Tier Two. Tier Three is for the person who
cannot tolerate prescription antibiotics or when the prescriptions do not work. Tier One
combinations appear to work 90 percent of the time and Tier Two about 80 percent of the time.
Tier Three seems to work 70 percent of the time or less.
As I noted above, there is no useful science to guide treatment decisions for Bartonella in
someone who has Lyme. What follows is based on my experience treating Bartonella in Lyme
disease. In general, if a treatment is working, the symptoms of Bartonella should start to improve
in one to two months. If they do not start to improve, then change to a different regimen. Read
more about Bartonella symptoms in It Could Be Bartonella or Babesia: The Symptoms and
Signs.

Tier One
Rifamycin-based Treatments
In these treatments, rifampin or rifabutin is the main effective ingredient. Combine rifampin 300
mg 2 pills 1 time a day or rifabutin 150 mg 2 pills 1 time a day with one of the following:

• Minocycline 100 mg 1 pill 2 times a day,
• Bactrim DS 1 pill 2 times a day or
• Azithromycin (Zithromax) 500 mg 1 pill 1 time a day.
Doxycycline 100 mg 1 or 2, 2 times a day can be substituted for the minocycline, but rifampin
decreases doxycycline levels in the blood. Clarithromycin (Biaxin) 500 mg 1 pill 2 times a day
can be substituted for azithromycin, but rifampin also decreases clarithromycin blood levels.
One way to make this treatment stronger is to double the dose of the rifampin from 300 mg 2
pills 1 time a day to 300 mg 2 pills 2 times a day.

Bactrim-based Treatments
Combine Bactrim DS 1 pill 2 times a day with either a macrolide or a tetracycline.
Use one of the following macrolides:

• Clarithromycin 500 mg 1 pill 2 times a day or
• Azithromycin 500 mg 1 pill 1 time a day.
Or use one of these tetracyclines:

• Doxycycline 100 mg 1 or 2 pills 2 times a day,
• Minocycline 100 mg 1 pill 2 times a day, or
• Tetracycline 500 mg 1 pill 3 times a day.
Fluoroquinolone-based Treatments
Fluoroquinolones are a class of antibiotics that include a number of members like levofloxacin
(Levaquin) and ciprofloxacin (Cipro). Combine levofloxacin 500 mg 1 pill 1 time a day or
ciprofloxacin 500 mg 1 pill 2 times a day with one of the following:
• Minocycline 100 mg 1 pill 2 times a day,
• Doxycycline 100 mg 1 to 2 pills 2 times a day, or
• Bactrim DS 1 pill 2 times a day.
Clarithromycin and azithromycin are not used with fluoroquinolones because together they may
cause heart rhythm problems. Levofloxacin seems stronger than the ciprofloxacin.
Use Fluoroquinolone-based treatments as a last resort, because they occasionally can cause
permanent tendon pain or even breakage.

Tier Two
A Macrolide Plus a Tetracycline
Use one of the following macrolides:

• Clarithromycin 500 mg 1 pill 2 times a day or
• Azithromycin 500 mg 1 pill 1 time a day.
Combine these with a tetracycline:

• Doxycycline 100 mg 1 or 2 pills 2 times a day,
• Minocycline 100 mg 1 pill 2 times a day, or
• Tetracycline 500 mg 1 pill 3 times a day.
Tier Three
Houttuynia plus Sida Acuta
I started using these two herbs together in the summer of 2015. This combination effectively
supports a bartonella treatment about 70 percent of the time. Start houttuynia at 5 drops 2 times a
day and increase daily by 1 drop per dose till at 30 drops 2 times a day. At the same time, take
sida acuta 1/4 tsp 3 times a day and after 1 week if tolerating it increase to 1/2 tsp 3 times a day.
Prior to using this combination, I was not impressed with other herbal options. For instance, I
have tried a formula called A-BART by Byron White, which are herbs that seem to help less than
50 percent of the time. Likewise, houttuynia by itself only works 50 percent of the time.

Treatment Course
For most of the combinations described above, treatment requires four to six months. The only
exception to this is a treatment that includes levofloxacin, which typically requires one to three
months. Treat until most of the Bartonella symptoms go away. Fortunately, 95 of people recover
from Bartonella using the immune supports and Tier One or Two approaches. The remaining
five percent may have relapses or require continuous antibiotics to keep Bartonella under control.
If a person relapses, three antibiotic combinations work well.

Disclaimer
The ideas and recommendations on this website and in this article are for informational purposes
only. For more information about this, see the sitewide Terms & Conditions.
References

  1. Buhner SH. Healing Lyme Disease Coinfections: Complementary and Holistic Treatments
    for Bartonella and Mycoplasma. Rochester, VT: Healing Arts Press; 2013.
  2. Biswas S, Rolain J-M. Bartonella infection: treatment and drug resistance. Future
    Microbiol. 2010;5(11):1719-1731. doi:10.2217/fmb.10.133.
Dr. Raymond Oenbrink