Doxycycline is the standard first line drug for Lyme disease. During the summer because of reactions to sunlight we frequently prescribe either amoxicillin or Ceftin. These drugs as mono-therapy are inherently problematic. They have no activity against a number of co-infections, such as Anaplasma, Ehrlichia, Bartonella and Babesia. Doxycycline may have a modest effect against both Bartonella and Babesia, particularly early on.
There is another germ which I have underplayed and may be highly significant. Mycoplasma. Most Mycoplasma species are not tick borne but M. fermentans can be tick borne. Other common species of Mycoplasma include: M. pneumonia, M. penetrans, M. hominis.
Mycoplasma bacteria are the smallest living organisms known: most don't consider viruses living. These tiny microbes are cell wall deficient and can survive only within cell
Most doctors are only familiar with M. pneumonia which is associated with "walking pneumonia." Another variant is associated with an STD.
I am looking at a review article by Endresen. Evidence is presented that Mycoplasma is highly associated with chronic fatigue syndrome, fibromyalgia and Gulf War Syndrome.
There is a trend in medical literature to claim that fibromyalgia and chronic fatigue syndrome are one and the same disease.
Other papers has shown a clear relationship of Mycoplasma with inflammatory arthritis, including rheumatoid arthritis.(not mentioned here).
He reports that patients with more than one species of Mycoplasma detected have disease of greater severity.
It is interesting: he discusses Mycoplasma as a potential coinfection in patients with CFS/FMS and mentions: Chlamydia, brucella? enteric bacteria like Proteus? and various viruses.
I think Brucellosis has been causing a chronic "Lyme-like" disease for decades before Lyme came on the scene. This is certainly not a mainstream view.
Why couldn't he mention the "L word." Is it that much of a third rail for academic researchers?
He even talks about treatment. He discusses the use of Minocin, Cipro, Biaxin, Zithromax but downplays the role of doxycycline.
It seems this has something to do with a clinical trial sponsored by the US defense department study of veterans with Gulf War Syndrome treated with doxycycline for one year.
We know that Garth Nicolson has strong views on the topic.
The author believes that short courses of antibiotics are frequently associated with relapse and that one year of treatment may be required for recovery.
Once again, long-term antibiotic therapy may be acceptable as long as it is not for Lyme.
Mycoplasma should be considered a potentially significant player and I suspect that doxycycline works as well as minocycline and that antibiotics need to be used in combination for effective therapy.