Treatment Guidance for Bartonella

I treat mostly pediatric patients who present with significant neurological manifestations of Bartonella. Often parents are overwhelmed with the treatment regimen prescribed and ask if all components are necessary. The short answer is yes! I hope this guidance provides better understanding of the nature of Bartonella and why it’s such a tricky bug to treat!

Bartonella Treatment with Lyme Disease and other Tick-borne Diseases

Recent studies show show effective Bartonella treatments must kill growing germ forms and “persister” or hibernating forms of Bartonella along with biofilm busters to prove an effective treatment.

Research published in 2019 is changing our approach to treating Bartonella. In the past, research showed rapidly growing germ forms of Bartonella prompting treatment that targeted these forms only. Research shows now that Bartonella also has stationary forms called persisters.  Persisters  are a dormant form of the bacteria that is impervious to  most antibiotics and immune system defenses. Research shows Bartonella forms a protective slime covering called biofilms. Biofilms block the immune system and antibiotics from reaching Bartonella. Research by Dr. Zhang of John Hopkins shows in vitro proof of biofilm response in his new research.

My approach to treating Bartonella addresses all mechanisms of the bacteria. The regimen may be overwhelming at first but proves effective if followed.

• combination herbal and antibiotics to address both growing and persister Bartonella forms

• herbals, neutraceuticals and medications to address biofilms

• Immune modulators via medication and herbals, neutroceuticals to boost immune function and focus upon anti-inflammatory properties to quell inflammation caused by  cytokines.

Intracellular antimicrobials are necessary to address intracellular activity (inside of the cell) where Bartonella likes to reside.

I use many combinations of antibiotics, herbals, IV therapies and DNA genetic therapies in my clinical practice when formulating an integrative, comprehensive treatment protocol. I would estimate most of my patients reach a recoverable steady state of wellness.

When treating Bartonella: What Works Best

Ying Zhang, MD and his colleagues at Johns Hopkins show that rifampin and azithromycin are the strongest agents. Other mentionable combinations include doxycycline, methylene blue, oregano oil, and ciprofloxacin. Other antibiotic combinations in the same family of antibiotics also prove effective. I do not use ciprofloxacin in my pediatric patients given the risk of tendon rupture and permanent damage.

Persister Bartonella

Methylene blue, oregano oil, allicillin, cinnamon, clove, clotrimazole effectively against persister cells and biofilms. Combinations of azithromycin/methylene blue, rifampin/methylene blue, azithromycin/ciprofloxacin, and rifampin/ciprofloxacin are also effective.

Bartonella Biofilms:

 More about Essential Oils

 Johns Hopkins University has identified 32 essential oils highly effective in vitro against stationary phase Bartonella– the stage in bacterial life cycle where bacteria do not grow along with growing phases of the bacteria.

The top 10 in order of effectiveness are as follows:

1. Cinnamon bark- effective against stationary phase Bartonella and eradicate all bacterial cells.

2. Oregano was found to be just as effective as cinnamon bark – producing eradication at .01% concentration in vitro.

3. Elemi

4. Mountain (winter) savory

5. Cedarwood

6. Ylang Yang

7. Citronella

8. Clove bud

9. Geranium

10. Allspice

Sounds like you’re baking a cake right? I utilize a compounded liposomal formula of cinnamon/clove/oregano oil by Doctor Inspired Formulation as well as a supplement by Researched Nutritionals called Biodisrupt and Elim-A-Cand that I find to be both tolerable and effective.

Several Steps to include when building a treatment regimen for Bartonella.

I discuss the importance of each step as integral to recovery with my patients.

Step 1.The Immune System & Inflammation

It is critical for Bartonella recovery to modulate the immune system. Modulating the immune system is addressed by:

·         decrease inflammation cytokines thru use of neutraceuticals, tempering the autonomic nervous system thru meditation and yoga, use of high tech therapies like EBO2 and IV nutrients. Red light therapy, halotherapy, sauna, and medications that address mast cells.

·         By addressing inflammation and rebalancing the autonomic nervous system, the immune system will follow.

·         correct hormone imbalances particularly adrenal function.

·         provide essential micronutrients

·         clean up the gut by removing yeast and other bacterial overgrowth in the intestines, decrease inflammation and improve motility.

Step 2. Do Not Pulse Antibiotics

Research suggests Bartonella replicates every 24 hours. I do not find pulsing antibiotics to prove effective in treating Bartonella.  

Step 3. Use Combination Antibiotics, herbals and neutraceuticals along with hefty Biofilm Breakers to quell Bartonella

Triple + combinations of antibiotics, primarily intracellular along with herbals that show effectiveness are necessary to fully address growing and stationary forms of Bartonella. There is no set protocol available, and treatment is highly individualized. In my experience with a heavy pediatric population, additional coinfections albeit tickborne, viral, other bacteria, mold or otherwise plays a significant role in the person’s ability to heal. Age is a factor as some intracellular antibiotics are not appropriate for young children and pose high risks. Tolerance and compliance are also a component when formulating a treatment plan to include all elements of a protocol.

I typically follow up frequently with my patients, every 6-8 weeks to re-evaluate treatment plans and make necessary changes.

 Bartonella Treatment Approaches

Combinations of pharmaceuticals and neutraceuticals that address active and dormant forms of Bartonella as well as biofilms.

·         (rifampin or rifabutin) plus (azithromycin or clarithromycin) plus (methylene blue and cinnamon/clove/oregano oil, Allimed and biodisrupt)

·         (rifampin or rifabutin) plus (doxycycline or minocycline) plus (methylene blue and Allimed, cinnamon/clove/oregano oil and biodisrupt)

·         (azithromycin or clarithromycin) plus (doxycycline or minocycline) plus (methylene blue and cinnamon/clove/oregano oil, Allimed and biodisrupt)

·         (rifampin or rifabutin) plus (Bactrim DS) plus (methylene blue and cinnamon/clove/oregano oil, Allimed and biodisrupt

·         (azithromycin or clarithromycin) plus (Bactrim DS) plus (methylene blue or oregano oil)

·         BLT/Crypto-Plus and Myc-P drops by Researched Nutritionals: 1 drop 2 times a day and increase daily by 1 drop per dose till at 40 drops 2 times a day.

I’ve tried Byron White products and do not recommend given lack of clinical significant, sustainable results.  I use individual herbals thru herb pharma or neutramedix for very sensitive patients.

Treatment Course

Treatment differs per person given underlying contributing factors. Most patients remain on treatment for roughly 6 months to a year. Many improve while a small percentage retain persistence despite treatment combinations. Other underlying contributing factors are identified in most cases, impeding wellness.

Disclaimer

Recommendations posted are suggestions and guidance. These do not replace clinical evaluation and treatment. Understand the importance of thorough evaluations with your provider to weigh risks and benefits of treatments.

References

1.      Buhner SH. Healing Lyme Disease Coinfections: Complementary and Holistic Treatments for Bartonella and Mycoplasma. Rochester, VT: Healing Arts Press; 2013.

2.      Zheng X, Ma X, Li T, Shi W, Zhang Y. Effect of different drugs and drug combinations on killing stationary phase and biofilms recovered cells of Bartonella henselae in vitro. BMC Microbiol. 2020;20(1):87. Published 2020 Apr 10. doi:10.1186/s12866-020-01777-9 (View)

3.      Li T, Feng J, Xiao S, Shi W, Sullivan D, Zhang Y. Identification of FDA-Approved Drugs with Activity against Stationary Phase Bartonella henselae. Antibiotics (Basel). 2019;8(2):50. Published 2019 Apr 29. doi:10.3390/antibiotics8020050 (View)

4.      Ma X, Shi W, Zhang Y. Essential Oils with High Activity against Stationary Phase Bartonella henselae. Antibiotics (Basel). 2019;8(4):246. Published 2019 Nov 30. doi:10.3390/antibiotics8040246 (View)

SOMER DELSIGNOREMARCH 18, 2022