I was diagnosed yesterday with Lyme disease. Don’t know much about it. The doctor actually pulled a tick out of one of my bullseye shaped rashes. I also have three other rashes on my body.
She prescribed a 2 week regimen of Doxycycline when the rashes first appeared. Once she definitively determined it was Lyme yesterday she switched me up to Sulphameth (sp).
Everything I’ve read online says I must use the doxycycline to treat it and that the Sulphameth is not effective at all for Lyme. It’s not just the all-knowing internet, but also a close friend who has had Lyme for decades is adamant that I must do the Doxy and at a higher dosage (400 mg per day) than the doctor’s RX of 200 per day or risk long term debilitating Lyme. Thoughts?
My wife went through this about 15 years ago, I guess it affected her for about 6 months total but no lingering effects once cured.
I can’t speak to the drugs, but it sounds like you should check with another Doctor. Hopefully you have a reasonable option.
Also I moved this from FQ to IMHO, this is where we generally put Medical questions.
All I can offer is the guideline from the American Academy of Pediatrics Committee on Infectious Diseases which advises doxycycline up to 200 mg per day divided in two doses for ten days for erythema migrans and fourteen days for early disseminated disease.
So yes questioning the plan seems reasonable.
fwiw, when I removed a deer tick from my husband, he called his doctor who put him on antibiotics immediately. The doctor said it wasn’t worth testing the tick, because… I forget, maybe there are enough false negatives that he’d want to treat my husband anyway. So I’m surprised your doctor had to wait to be certain after you had already presented with a bullseye rash surrounding a tick.
I’d go to another doctor for a second opinion. Lyme disease is nothing to fool around with.
Thank you puzzlegal but to clarify my doctor put me on Doxycycline immediately upon seeing my rashes. Then when she found the tick she changed me up to the other antibiotic.
From our guidelines:
Tick testing has very poor predictive value and is not recommended. If the tick bite occurred in an area with high endemicity, appears to have been a deer tick, and was estimated to have been on at least 36 hours, the it is considered high enough risk to give a single prophylactic dose of 200 mg doxycycline (or by weight for smaller kids).
The experts do not advise treating lower risk tick bites prophylactically.
According to widely accepted clinical guidelines, a history of even potential tick exposure in an endemic area and a classic rash justifies treatment for Lyme based solely on the clinical picture, without lab testing.
Sulfamethoxazole is not first-line treatment for Lyme.
I’m not a physician but i am a medical entomologist. Take the doxy.
Tick testing (at least where I live) isn’t cost effective. You get bit by a tick, it’s a coin flip whether it’s infected (we’ve tested). it costs about $100 to test the tick for Borrelia (you may not pay that, but that’s what it costs). The doxy treatment costs about $2.
Well, we live in a high risk area (the back yard neighbor’s dog had recently had Lyme, for instance), it was certainly a deer tick, and my husband had no idea how long the tick had been there. And as mentioned above, the antibiotic is cheap and it’s generally well tolerated.
Back to the OP, I’d think the rash plus the tick would be diagnostic.
Did your doctor tell you to stop taking the doxy, or did she tell you to take a second antibiotic, too?
Have you asked her why she’s prescribing something other than what’s usual for Lyme?
No offense, but don’t do that. Listen to your doctor and yes, it’s right to ask questions and get another opinion if warranted, but don’t make any decisions about your health and this particular disease based mainly on your own online “research”.
Not criticizing your husband’s care. Just sharing the guideline.
If I understand the story had the rash but tick not found for a while. Then, for reasons we do not know, switched medication. Maybe there is more to the specifics. We don’t know.
In today’s world, a good doctor who recommends something totally different than what wikipedia says is the standard treatment should be happy to explain to her patient why she’s doing that. 
There are things that are fairly staight forward that are listed online.
I think Doxy for Lyme is just that.
Barring info we don’t have about the OPs case.
So after texting back and forth with my doc I need to correct/ clarify.
She put me on the Sulphameth because of a secondary ailment that my blood work showed. She will get me back on the doxy within a few days pending the confirmation of Lyme.
No, Bactrim (sulfamethoxazole/trimethoprim) is not a standard treatment for Lyme disease, but it is for MRSA, which might be part of the infection.
My wife had the same thing. Two weeks of heavy antibiotics and she is OK now. It killed a classmate of mine
This account still doesn’t make sense to me.
Why would the doc withhold doxycycline “pending the confirmation of Lyme”? Note that antibody testing for Lyme may be falsely negative in the first few weeks of infection.
Testing and Diagnosis for Lyme disease | Lyme Disease | CDC.
Also, doxycycline and sulfamethoxazole (or trimethoprim-sulfamethoxazone a.k.a. Bactrim) are not supposed to be incompatible when taken at the same time.
There may be poor communication going on here but it’s worth getting straightened out and possibly a second opinion sought, from someone with training and experience in diagnosing and treating Lyme disease.
My biggest concern with taking doxycycline and TMP/SMX at the same time, in addition to GI issues if they’re taken together (maybe take the doxy at breakfast and supper, and the TMP/SMX at lunch and bedtime) is that both drugs cause increased sensitivity to sunburn.
Use sunscreen!
But doxycycline is an excellent rx for MRSA also. I always used it instead of Bactrim unless the patient had issues with that type of med.
I’d be staying on the doxy.
Me, too. I’d keep taking it while discussing what’s going on with my doctor. I think there’s a misunderstanding here. My guess is that when it’s straightened up, the recommendation will be that you should have been taking the doxy all along. But until the situation is totally clear, or you develop some horrible reaction to the antibiotic for Lyme, I’d be taking it.