QUESTION: I have a 33yoF who I have seen twice for Lyme disease. She had a poor reaction to antibiotics and thus we began herbal antimicrobials (Samento) which she was doing well on. She called to say she just found out she is pregnant (unplanned). I want to present her with any research I can and antibiotic and if possible herbal antimicrobial options to prevent vertical transmission. I have seen Ceftin 500mg BID as an option (Preg Cat B) but also heard of penicillin protocol which I cannot find the dosing protocol for. Would love any help and direction.
ANSWER: To my knowledge there are no true evidence based guidelines for this even though the CDC admits vertical transmission is possible.
Beta lactams (Cef’s and Penn’s) are most often mentioned in pregnancy. I’d rotate Penicillin VK 500 mg TID with food one week and Augmentin 875 mg BID with food the next week. I’d do that one month in earlier PG and for month 7-8.
Alternates are rotating Cef’s.
I’d definitely keep up the natural anti-infectives throughout.