Late stage Lyme disease treatment might include azlocillin in the future.

Woman sleeping in car who needs late stage lyme disease treatment

A study by Stanford Medicine indicates that a drug called azlocillin “completely kills off the disease-causing bacteria Borrelia burgdorferi at the onset of the illness.” [1] In addition, the authors say, azlocillin “could be effective for treating [Lyme disease] patients infected with drug-tolerant bacteria that may cause lingering symptoms.”

Researchers identified azlocillin after screening nearly 8,000 drug compounds. They found that in the test tube and in mice, azlocillin was effective against drug-tolerant Borrelia burgdorferi s.s., the pathogen causing Lyme disease. But will late stage Lyme disease treatment soon include azlocillin, an FDA-approved drug that is often used to treat infections such as Pseudomonas aeruginosa and Escherichia coli? Stanford researchers say that is what they are working towards.

“This compound is just amazing,” says Rajadas, senior author of the study. “It clears the infection without a lot of side effects. We are hoping to repurpose it as an oral treatment for Lyme disease.”

Chronic Lyme disease

Unfortunately, treatment fails for too many patients with late stage Lyme disease. Multiple studies have shown that as many as 34% to 62% of patients have Lyme disease symptoms that persist long term despite treatment.

In fact, one study found that at their six-month follow-up visit, “36% of patients reported new-onset fatigue, 20% widespread pain, and 45% neurocognitive difficulties.”

When late stage Lyme disease treatment fails, chronic symptoms may be due, in part, to what scientists call ‘persisters,’ bacterial cells that are resistant to antibiotics.

“This compound is just amazing,” says Rajadas, senior author of the study. “It clears the infection without a lot of side effects. We are hoping to repurpose it as an oral treatment for Lyme disease.”

“These studies reveal that a small subpopulation of dormant B. burgdorferi persisters still survives with current Lyme therapy antibiotics,” says Pothineni and colleagues in the article, “Azlocillin can be the potential drug candidate against drug-tolerant Borrelia burgdorferi sensu stricto.” [1]

“The probable mechanisms as evidenced by scientific literature are the persister formation, evading the immune system by hiding in the privileged sites, surface lipoproteins modifications to avoid antigenic responses, biofilm formation, and immunomodulation,” explains Pothineni.

Azlocillin in mice

The authors inoculated mice with high doses of Borrelia burgdorferi (Bb) to test the effectiveness of each of the antibiotics. Doxycycline cleared the infection on Day 7 but did not clear the Borrelia bacteria at Days 14 and 21. Cefotaxime alone failed to eradicate the B. burgdorferi infection completely in mice who had been infected for 7 and 14 days.

Meanwhile, azlocillin completely cleared the infection in all mice but some B. burgdorferi DNA remained.

“Though the azlocillin eliminated B. burgdorferi infection completely in all the mice infected for 21 days, still 2 of 8 mice infected for 14 days had some B. burgdorferi DNA in ear tissues,” says Pothineni.

[bctt tweet=”Study finds azlocillin may be a game-changer for the treatment of persistent Lyme disease symptoms. ” username=”DrDanielCameron”]

The authors points out, “the drug combinations of 40 μg/ml azlocillin and 80 μg/ml cefotaxime is much more effective in killing persisters than using azlocillin alone.”

Treatment for patients

Unfortunately, treatments that are successful in the test tube and in mice, may not work in humans.

Azlocillin is a semisynthetic β-lactam drug that cannot be used in patients who are allergic to penicillin. Currently, it is only available intravenously and the dosage, duration, efficacy, and side effects in B. burgdorferi-infected patients has not been studied.

For now, there are a number of antibiotics that are better understood including oral doxycycline, amoxicillin, cefuroxime, cefdinir, azithromycin, and clarithromycin, as well as intravenous ceftriaxone and cefotaxime. And specific drugs are available to target tick-borne co-infections, such as atovaquone and azithromycin for the treatment of Babesia.

Lastly, medications, which have recently been studied in the laboratory or in mice are now being considered as late-stage Lyme disease treatment options. These include dapsone [2], a combination of daptomycin, ceftriaxone, and doxycycline [3-5], and disulfiram. [6]

  1. Pothineni VR, Potula HSK, Ambati A, et al. Azlocillin can be the potential drug candidate against drug-tolerant Borrelia burgdorferi sensu stricto JLB31. Sci Rep. 2020;10(1):3798.
  2. Horowitz RI, Freeman PR. Precision medicine: retrospective chart review and data analysis of 200 patients on dapsone combination therapy for chronic Lyme disease/post-treatment Lyme disease syndrome: part 1. Int J Gen Med. 2019;12:101-119.
  3. Feng J, Li T, Yee R, et al. Stationary phase persister/biofilm microcolony of Borrelia burgdorferi causes more severe disease in a mouse model of Lyme arthritis: implications for understanding persistence, Post-treatment Lyme Disease Syndrome (PTLDS), and treatment failure. Discov Med. 2019;27(148):125-138.
  4. Wozel G, Blasum C. Dapsone in dermatology and beyond. Arch Dermatol Res. 2014;306(2):103-124.
  5. Gonzalez-Ruiz A, Seaton RA, Hamed K. Daptomycin: an evidence-based review of its role in the treatment of Gram-positive infections. Infect Drug Resist. 2016;9:47-58.
  6. Liegner KB. Disulfiram (Tetraethylthiuram Disulfide) in the Treatment of Lyme Disease and Babesiosis: Report of Experience in Three Cases. Antibiotics (Basel). 2019;8(2).

44 Replies to "Late stage Lyme disease treatment might include azlocillin in the future."

  • Andy
    04/28/2022 (11:20 am)

    My case began in 1988. Had an accident at work. Back and neck injuries. But I was young and strong. I had just moved Upstate NY, had 1st child. Never saw the tick or had a rash. Went downhill for a year and a half till I was diagnosed. I went through Rocephin treatments, massive antibiotics, etc. for about eight years until I recovered enough to go back to work. Staying dormant in me for a number of years. I worked hard as a bus mechanic for years. I went for pain management. I received an epidural steroid. It triggered the bacteria in my body to Full Blown Lyme symptoms the next day! Had to retire from work.
    Almost died at home. Finally was treated at a Lyme literate doctor with bicillin injections. 6 months later, back to work. I’ve had NUMEROUS other treatments since (including Dapsone which did nothing for me) and I am currently suffering again. Woe is me.
    After 35 years of living in pain and all the drama associated with it, I would gladly volunteer for a study. Please keep me updated and consider me a great test subject. Thank you and bless you helping others.

    • Dr. Daniel Cameron
      04/28/2022 (11:55 am)

      I have not heard of any clinical trial for azlocillin.

      • Thomas
        07/16/2022 (4:19 am)

        So why isn’t the great doctor Cameron busy writing this script for all of this patients that’s the real question

        • Dr. Daniel Cameron
          07/16/2022 (6:45 am)

          Unfortunately, azlocillin is not on the market in the US. Once available, we need trials to determine whether the benefits of azlocillin are not just seen in the lab.

          • John Conforti
            09/25/2022 (10:21 pm)

            Thank you sir great work .

  • Linda Allen
    04/07/2022 (9:53 pm)

    My daughter has been suffering with lyme disease for years. She is a nurse but hasn’t been able to work for 4 years. She has been on an antibiotic protocol. Please let me know if this drug becomes available. Thank you!

    • Susan
      04/25/2023 (8:44 pm)

      It is available outside of the U.S. (Germany comes to mind).

  • Tara
    03/16/2022 (10:29 pm)

    I was diagnosed with lyme disease nearly 35 years after the onset of illness and symptoms. It is a tragic scenario that plays out everywhere. I finally got the brain scans, blood tests and treatment I needed (out of pocket of course), but the antibiotics failed miserably. I retested a few years later and I still have it. I have learned to live in a state of suffering and rejoice in the Lord! I have zero hope in any of the current treatments. It is the same with cancer. They will not release the cure. “They” want you sick and spending money. It is just the way it is. Put your hope in the Lord and look up! He is returning soon. Forget the “wisdom of man”…and seek the righteousness of God.

    • Nick C.
      04/22/2022 (10:21 pm)

      Amen Tara. I’ve only be suffering for 8+ years but as you know that’s 8+ years too much. I wish there were more awareness to our suffering. But in the meantime, our Lord knows our every suffering and is going to bring us home soon. God bless you in your health journey!

    • Brian
      11/07/2022 (1:55 am)

      Recently diagnosed with Lyme Disease that shattered my life 5 years ago. Sought countless physicians including the Mayo clinic and received the same results. “Tests are negative, must be chronic fatigue” which is the polite way of saying, “it’s all in your head”. Saw a Dr. in Seattle who ran the proper tests that insurance doesn’t cover and found high levels of mold along with positive Lyme. Azlocilin used to be prescribed in the US so I’m curious why it stopped being used since it’s FDA approved. I know the bottom line is money because it’s always the bottom line, but I’d love to know if there’s a way to be notified as soon as it’s available even if only in clinical trials. Thanks and keep doing good work.

      • Dr. Daniel Cameron
        11/07/2022 (4:25 pm)

        I have not seen any Azlocillin trials in the US. I have had to use treatments for now. Sorry.

  • Leigh Davies Krohmal
    10/23/2021 (10:53 pm)

    Please let us know as soon as Azlocillin trials are available.

  • Rick Vanden Heuvel
    09/05/2021 (12:58 am)

    Dr Cameron, I certainly hope this new drug azlocillin comes out soon.
    As for so many, my life has been on hold for 14 years. Ive done just about everything I can think of or find out about. I have led Lyme support meetings and helped others as I can. But my family has 3 members with chronic lyme, and it has really messed up our lives. Tragedy has been waiting around every corner.
    Id gladly join a trial of azlocillin. Im about as detoxed as I can be. The biggest difference for me has been heavy metal chelation. In fact, I found that even small amounts of DMSA can disrupt the biofilm formation in a bigger way than antibiotics has ever done.
    Now I mostly take mother wort., enzymes, DMSA, ALA and a few others supplements. I stopped taking the imported herbs that were contaminated with metals. And it has worked out ok. But any drop of sugar or carb sends me backwards.
    WE need that Azlocillin!

    • Greg
      10/30/2022 (9:41 pm)

      As a LONG TIME Late Stage Lyme sufferer who had multiple bullseye rashes on my stomach in 1986 , I had never heard of Lyme Disease in the 80’s so I didn’t go to a Doctor until 10 years later because my then 34 year old body felt like it was 140 , I would try just about ANYTHING right about now 😏😏😏😏

1 2 3

Join the Lyme Conversation
(Note: comments are moderated. You will see your comment after it has been reviewed.)

Some html is OK