Antibiotics have been hailed as the super cure in their vaulted past, but over the years, as people have begun to die and suffer terrible side effects due to over-use, and still others who become sick from even a small amount of antibiotics, there is a new wave of bad publicity towards antibiotics, rightly so when taken casually.

But for those of us with chronic Lyme disease, the risks involved with taking antibiotics – for years even- are absolutely worth it.  Many will admit to thinking that death is not a punishment compared to the hell we live with each day.

To better understand  how antibiotics work it helps to learn about the mechanism of the action they employ. Generally speaking, antibiotics fall into two categories:

• Bactericidal-An agent that directly destroys bacteria.
• Bacteriostatic – An agent that arrests or hinders the growth of bacteria.

Antibiotics that are bactericidal (for example, think… homicidal) can directly attack the cell wall of the bacteria. This causes a rupture and the death of the organism follows. Antibiotics from the penicillin family of antibiotics are usually bactericidal, unless concentrations fall too low.

Antibiotics that are bacteriostatic (for example, think… manipulative) do not directly attack bacteria. Instead, they interfere with the ability of the organism to reproduce. Without the ability to reproduce the bacteria can eventually die out.

Bacteriostatic antibiotics include tetracyclines such as Doxycycline. It is important to remember that most antibiotics can be both bactericidal and bacteriostatic, depending upon the amount or concentration of the antibiotic in the body. More clearly still, most bacteriostatic antibiotics can become bactericidal if the concentrations are strong enough.

One of the main points to understand about bacteriostatic antibiotics is that they are usually effective in debilitating bacteria only when bacteria reproduce.

This is significant for two reasons.

First, it is believed that dormant Lyme bacteria don’t reproduce, which diminishes bacteriostatic antibiotic’s effectiveness in fighting Lyme disease.

Second, Lyme bacteria have a long reproductive cycle. A mature Lyme bacterium reproduces once every 7 hours or so. This reproductive cycle may vary from species to species. In comparison, some species of the strep throat bacterium reproduce once every 20 to 30 minutes. It is not known how many reproductive cycles are needed before all Lyme bacteria are debilitated by antibiotics.

However, according to Karen Vanderhoof-Forschner in her book, “Everything You Need To Know About Lyme Disease”, the strep bacterium is normally treated with antibiotics through 480 reproductive cycles.

She says that if we were to treat Lyme disease through the same number of cycles it would take somewhere between 5 to 30 months of antibiotic therapy. If this is true, it is significant that some physicians follow a protocol for treating Lyme disease that allows just two to six weeks of antibiotic therapy. Based on the above scenario this may be inadequate.

If either of the above examples are true, this may mean that physicians who are acting in good faith by using conservative treatment protocols may actually be prolonging and thus complicating Lyme infection in their patients. However, much of this theory is speculative. Obviously, more research is needed.

Lyme physicians take all of this relatively new knowledge about bacterial biology into account when deciding which antibiotic, or combination of antibiotics to prescribe.

The above scenario suggests that, depending upon dosage, some classes of antibiotics such as penicillins and cephalosporins may not be able to eradicate Lyme bacteria from the body because they circulate mainly in the body’s fluids and are incapable of entering cells where the Bb organism can reside.

If true, this contradicts many current conservative antibiotic protocols for Lyme disease.

The good news is that other classes of antibiotics, such as macrolides (azithromycins such as Zithromax) are prescribed specifically to attack the Bb bacteria that may become established within the body’s cells, along with killing Lyme bacteria residing outside the cells in deep tissue areas of the body.

It is important to recognize that this is a case in point where a shotgun approach to antibiotic therapy may be an effective tool in fighting Lyme disease.

For example, a physician may prescribe a penicillin such as Amoxicillin, along with a macrolide such as Zithromax. The Amoxicillin stays mostly in the body’s fluids and blood stream. Meanwhile, Zithromax not only penetrates the cell wall where the Bb organism is residing (and/or hiding), but it also penetrates deep tissue areas, which Lyme bacteria also inhabit. When Lyme bacteria move to deep tissue areas they have effectively moved away from normal blood flow and away from fluid-based antibiotics. Antibiotics such as Zithromax can help to counter this survival tactic.

Also, Amoxicillin is mainly bactericidal (remember, think… homicidal), which means that it directly kills the Bb organism. Zithromax is a macrolide, which means that it can either be bactericidal or bacteriostatic (think… manipulative) depending upon concentration levels.

By prescribing these two antibiotics, physicians hope to increase the opportunities for killing as many bacteria as possible, and affecting Lyme bacteria in numerous and complex ways. And of course many doctors disagree on combinations and length of treatment – especially given the potential of significant health hazards and potentially lethal side effects.

Even though physicians can out-maneuver some of the Lyme bacterium’s survival tactics-such as using combinations of antibiotics-there are those who believe that antibiotics probably cannot eliminate the Bb organism if it is in a dormant state. Again, if this is true, it has serious consequences for the diagnosis and treatment of chronic, persistent symptoms.

Specifically, this means that conservative treatment protocols, which call for short-term courses of antibiotics, may actually prolong some cases of Lyme infection. If chronic Lyme symptoms are the result of an active, late-stage Lyme infection, any delay in full and comprehensive antibiotic treatment may have devastating results for the Lyme patient.

It is easy to understand from the above facts and figures how many patients would get impatient to feel betters, and consequently try some conservative  ”alternative” protocols, and some outlandish “alternative” protocols: both in addition to antibiotics or instead of antibiotics.

There is emerging evidence that certain antibiotics may be more readily incorporated into the cell wall of the bacteria itself in the presence of elevated oxygen tension, which is an environment similar to that created in the body during Hyperbaric Oxygen therapy (HBOT).

If true, this is a clear example of HBOT working in a synergistic manner with antibiotic therapy. In other words, the effectiveness of antibiotics to kill the Lyme organism is increased through the use of HBOT.

Research is currently being conducted that may indicate that the Bb organism can be killed by oxygen free radicals. Oxygen free radicals are produced during HBOT. The deeper the depth of treatment, the greater the number of free radicals produced. It is believed by many that oxygen free radicals have an antibiotic-like effect.

Finally, it is well understood that HBOT can enhance certain aspects of the body’s natural immune system. This may play a significant and positive role for Lyme patients because their immune systems have probably been compromised over a long period of time as a result of persistent symptoms.

“Lyme Times” the magazine published by the California Lyme Association, wrote extensively about alternative treatments (in a back issue) and concluded emphatically that antibiotics are the key to a permanent cure for chronic Lyme disease.

I think I will re-evaluate the many supplements I take, but I feel strangely comforted that although I try most every alternative protocol, I have never stopped my antibiotic treatments – just variations and pulsing.

I am finally feeling really good for longer periods of time…so can you tell me if it is the antibiotics, the alternative protocols or both?