FOR ACUTE AND PERSISTENT LYME DISEASE

THE OPTIMAL TREATMENT HAS YET TO BE DETERMINED

Disclaimer: The following information is for educational purposes only, and should not be taken as medical advice or used for self treatment. Always discuss any prospective treatments–even natural ones–with a medical practitioner.

   

Traditional Antibiotics Are Not Effective

In a 2014 study by a team at Johns Hopkins, commonly prescribed antibiotics recommended by the CDC for the treatment of Lyme Disease fell short of eradicating the disease in both log and stationary phase cultures

Background

In Lyme Disease treatment, there are two phases of bacterial growth of interest:

  1. The logarithmic (log) phase– a period of exponential (rapid) growth, like in an acute infection.
  2. The stationary phase- a period when bacterial population growth has stabilized, like in a chronic disseminated infection. In this phase, Borrelia burgdorferi, the bacteria that causes Lyme, is more resistant to antibiotics.

There are also three forms of B. burgdorferi worth noting:

  1. Spirochetes– the corkscrew shaped cells that Lyme is known for. 
  2. Round bodies (also referred to as cysts)– spirochetes have been shown to turn into round shaped forms in response to unfavorable environmental conditions, including antibiotic exposure. Round bodies have been found in vitro to be more resistant to antibiotics than spirochetes, and can revert back to spirochetes when conditions are suitable.
  3. Biofilms– microcolonies of spirochetes and round bodies shielded from hostile environments by a protective layer, shown in vitro to be the most antibiotic resistant form of B. burgdorferi.

Hopkins Research Shows

B. burgdorferi spirochetes in the log phase are highly susceptible to doxycycline and amoxicillin, two CDC recommended and commonly prescribed oral antibiotics for Lyme Disease. However, when used against a seven day old stationary phase culture (mainly biofilms and round bodies), doxycycline and amoxycillin left 75% and 76% viable cells, respectively. This direct correlation between time and treatment outcome reinforces that delayed diagnosis and treatment highly increase the chances of a patient developing persistent infection.

The study found 165 FDA approved drugs were more effective against stationary phase cultures than amoxicillin and doxycycline.

Some drugs found to be effective against round bodies are ineffective against biofilms and vice versa, highlighting the differences between biofilms and round bodies. This, along with the fact some antibiotics and other therapies only affect certain forms (spirochetes, round bodies, and biofilms), suggests a treatment plan must address all forms of B. burgdoferi.

Takeaway: optimal treatment for both acute and chronic/persistent Lyme Disease has yet to be determined. However, it is clear there are much better treatment options for acute Lyme than are currently being used. The possibility of antibiotic resistant cells forming early on in infection or being transmitted by a tick needs to be addressed. 


Additional Hopkins Research

Since the original 2014 study, Johns Hopkins has conducted additional research to identify more effective treatment options (in culture) than currently prescribed antibiotics.

2015

Drug Combinations against Borrelia burgdorferi Persisters In Vitro: Eradication Achieved by Using Daptomycin, Cefoperazone and Doxycycline

The longer Lyme is allowed to disseminate in a host, the more antibiotic resistant it becomes.

  • Three day old log phase cultures of B. burgdorferi were found to contain 96% spirochetes, only 4% antibiotic resistant round body forms, and no antibiotic resistant biofilms.
  • Seven day old stationary phase cultures were found to contain 38% spirochetes, 23% round body form, and 39% biofilms.
  • Ten day old cultures shifted to 20% spirochetes, 16% round body, and 64% biofilms.

Biofilm/microcolony forms of B. burgdorferi were not eliminated by any one drug (doxycycline, amoxicillin, or any of the drugs the authors had previously proved to be effective against stationary phase cells) or any two drug combination. Only the combination of doxycycline, cefoperazone, and daptomycin could completely eradicate the microcolonies.

However, daptomycin is expensive, must be administered intravenously, and has limited penetration through the blood-brain barrier, so the authors sought better options. 

Identification of new compounds with high activity against stationary phase Borrelia burgdorferi from the NCI compound collection

237 compounds in the National Cancer Institute compound library collection were found in vitro to have higher activity against stationary phase B. burgdorferi than doxycycline and amoxicillin.

2017

Selective Essential Oils from Spice or Culinary Herbs Have High Activity against Stationary Phase and Biofilm Borrelia burgdorferi

27 essential oils were more effective against stationary phase cultures than doxycycline, and 22 were more effective than cefuroxime (another CDC recommended antibiotic).

It’s important to note that the efficacy of these essential oils in vivo (in humans and animals) for treatment of Lyme Disease has not been measured.

2018

Identification of Essential Oils with Strong Activity against Stationary Phase Borrelia burgdorferi

An additional 34 essential oils were found to be more effective against stationary phase cultures than doxycycline, and 25 were more effective than cefuroxime.

2020

Evaluation of Natural and Botanical Medicines for Activity Against Growing and Non-growing Forms of B. burgdorferi

Seven botanical medicines were found to have better activity against stationary phase cultures of Lyme than doxycycline and cefuroxime. One of those botanical medicines, Cryptolepis sanguinolenta, was found to have strong activity against the log phase as well, making it a potential candidate for acute Lyme Disease—it would break up any biofilms, making it harder for the bacteria to persist—as well as chronic/persistent Lyme Disease. The authors called for further studies into the potential role of Cryptolepis sanguinolenta in Lyme treatment.