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Dr. Andrew Rynne

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Can Azithromycin and Doxcycline be combinedly taken for lyme treatment?

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Dr. Chakravarthy Mazumdar

General & Family Physician

Practicing since :2004

Answered : 1778 Questions

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Posted on Wed, 6 Aug 2014 in Infections
Question: Im currently being treated for Lyme. I have taken Doxcycline for 2 1/2 weeks, but my doctor now wants me to take only azithromycin. From what Ive researched it seems the two together could actually be pretty effective as they attack the bacteria's ability to synthesis proteins differently. My question is Would it be smart & safe to finish off the original suggested 4 week course of Doxcycline(100mg 2 D) with the now additional azithromycin(250 mg 1 d)? Or should I discontinue and switch directly to only taking the azithromycin?
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Answered by Dr. Chakravarthy Mazumdar 7 hours later
Brief Answer:
Finish off the original Doxycycline for 3 weeks

Detailed Answer:
Hi,

The antibiotic of choice for Lyme disease depends on the symptoms or manifestations of the disease. To be honest I have not read Azithromycin as a first line drug unless there is Penicillin allergy documented.

1) Stage 1: rash we treat with either Oral Doxycycline or amoxicillin for 3 weeks
2) Stage 2: Neurological problem (meningitis, Bells palsy) Intravenous ceftriaxone (Penicillin group)
3) Stage 3: Cardiac heart block again IV ceftriaxone
4) Arthralgia, we go with doxycycline for 3 weeks.

I agree with the school of thought that both Doxy and Azithro have different class of action but multiple antibiotics at the same time is the last bullet. If the Doxycillin does not help in 3 weeks there is no point in going ahead with it. It is better to switch to alternative therapy.

Since you completed 2 1/2 weeks, continue for another half week and stop it and switch. With that point of view you can go ahead with your doctor's treatment with Azithromycin.

Hope this helps.

Above answer was peer-reviewed by : Dr. Aparna Kohli
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