Combining Double-Dose and High-Dose Pulsed Dapsone Combination Therapy for Chronic Lyme Disease/Post-Treatment Lyme Disease Syndrome and Co-Infections, Including Bartonella: A Report of 3 Cases and a Literature Review.
Level 4 - case-series / case-control
Case series reporting clinical outcomes in 3 patients.
PubMed 38792737 · doi:10.3390/microorganisms12050909
What was done
Three patients with relapsing and remitting borreliosis, babesiosis, and bartonellosis despite previous extended anti-infective therapy were treated with double-dose dapsone combination therapy (DDDCT) for 8 weeks, followed by one or several short courses of pulsed high-dose dapsone combination therapy (HDDCT) combined with rifampin, methylene blue, pyrazinamide, and anti-malarial/herbal therapies while addressing factors on a 16-point systemic model.
What was found
The abstract provides no numerical outcome data, scores, or statistical measures. It qualitatively reports that prior oral, intramuscular, or intravenous antibiotic therapies were inferior to the pulsed regimen, which improved resistant fatigue, pain, headaches, insomnia, and neuropsychiatric symptoms, leading to clinical remission.
Why it matters
This report describes an aggressive multi-agent combination regimen targeting persistent symptoms attributed to chronic Lyme disease and co-infections, serving as an anecdotal protocol report for further clinical research.
Limits
The report is an uncontrolled series of only 3 patients, precluding any causal inference or comparative efficacy conclusions. The abstract reports no objective or quantitative outcome metrics, no controls, and no standardized safety monitoring data. The findings are highly susceptible to placebo effect, symptom fluctuations, and reporting bias.
Cited by
- partial Dapsone exhibits antimalarial activity and is effective against approximately 25% of Babesia cases.