Friday, July 18, 2008
Why does Rifampin work so well?
Rifampin is a relatively weak antibiotic. It is tremendously helpful for many patients. It works by a unique mechanism. It inhibits bacterial RNA synthesis. In the past its primary uses have been as an adjunct for TB and meningitis prophylaxis post exposure. It is known to kill Lyme, but is relatively weak compared with other antibiotics. Studies show that it a Doxycyline alternative for Erlichia infection. It is effective against Bartonella. Dr. Stratton has shown it is a key part of his regimen for CPN. Is it killing co-infections? Is it synergistic with other antibiotics as in the treatment of TB? I don't know. More research is needed. It seems to be an extremely helpful drug when used as part of a multi-drug regimen for chronic Lyme disease or Lyme Disease Complex, as some call it. Typically it is added to regimens which include Amoxicillin or Ceftin plus Biaxin or Zithromax and Plaquenil or Doxycycline/Minocyline. Flagyl is an option. I don't tend to use Rifampin initially because most patients respond without it. For difficult cases it has proved to be very helpful. Comments are welcomed.