Antibiotics for Lyme, Strep and PANS/PANDAS

Blog Antibiotics for Lyme, Strep and PANSPANDAS
Dr. Roseann Capanna-Hodge

Dr. Roseann Capanna-Hodge

For some parents, the use of antibiotics might seem daunting, especially when it comes to treating conditions like Lyme disease, strep throat, and PANS/PANDAS. Over the years, I've witnessed the challenges parents face when their little ones battle these conditions. Allow me to help clarify how antibiotics fit into the Lyme treatment puzzle. 

Differentiating Lyme Disease, Strep, and PANS/PANDAS

One of the critical distinctions between Lyme disease and strep throat lies in their respective causes. Lyme disease is caused by the bacterium Borrelia burgdorferi, transmitted through infected ticks' bite. On the other hand, strep throat is caused by Group A Streptococcus bacteria, typically spread through respiratory droplets.

While both conditions may present overlapping symptoms like fever and fatigue, they have distinct diagnostic criteria and require tailored treatment approaches. Lyme disease may necessitate longer treatment of antibiotics due to its potential to cause persistent infection, whereas strep throat often responds well to shorter antibiotic regimens.

While Lyme disease and strep throat have distinct causes and treatment approaches, PANS/PANDAS require specialized evaluation and management strategies focusing on addressing the underlying autoimmune component and infection management. Accurate differentiation among these conditions is crucial to ensure appropriate diagnosis and treatment.

Understanding Antibiotics: The Basics

Antibiotics are medications designed to combat bacterial infections by either killing the bacteria or preventing their growth. But understand that antibiotics are effective against bacterial infections, not viral ones. This crucial distinction is often overlooked but can significantly impact treatment decisions.

Antibiotics are vital in managing  Lyme disease, strep throat, and PANS/PANDAS. If left untreated, Lyme disease, transmitted through tick bites, can lead to various symptoms ranging from fatigue to neurological issues. 

Strep throat, caused by the Streptococcus bacteria, can result in throat pain, fever, and swollen glands. PANS/PANDAS, though more complex, are also believed to have bacterial origins and can manifest as sudden-onset behavioral and cognitive changes in children.

One study aimed to determine the optimal treatment for patients with cognitive impairment persisting or returning after standard intravenous (IV) antibiotic therapy for Lyme disease. Patients with documented Lyme disease, prior IV antibiotic treatment for at least three weeks, positive IgG Western blot, and objective memory impairment were included. 

They were randomly assigned to receive ten weeks of double-masked treatment with IV ceftriaxone or IV placebo, followed by no antibiotic therapy. The primary outcome was neurocognitive performance at week 12, focusing on memory. Durability of benefit was assessed at week 24. Results showed that antibiotic-treated patients exhibited significantly improved cognitive performance across six domains at week 12 compared to placebo (Fallon et al., 2008)

What is a Biofilm

Pulsing Antibiotic Treatment: Breaking Through Biofilm

Another aspect of antibiotic treatment worth discussing is pulsing therapy, particularly in the context of Lyme disease. Lyme bacteria can remarkably form protective biofilms, making them more resistant to traditional antibiotic therapy. 

Studies show that the disease’s antibiotic resistance and recurrence may be linked to these biofilm-like aggregates formed by Borrelia bacteria, enabling them to resist antibiotics and harsh environmental conditions. This increased tolerance to antibiotics resembles the behavior of bacteria in biofilms, potentially playing a role in developing various manifestations of Lyme disease, including Lyme neuroborreliosis (Di Domenico et al., 2018).

Pulsing antibiotics involves cycling between antibiotic administration and rest periods, disrupting biofilm formation and targeting the bacteria more effectively. This approach has shown promise in some cases of chronic Lyme disease, where conventional treatments have fallen short. 

Again, it's essential to work closely with a knowledgeable healthcare provider experienced in treating Lyme disease to determine the most appropriate treatment plan for your child's unique situation.

Herbal vs. Antibiotic Treatment for Lyme and Tick-Borne Disease

Herbal Remedies vs Antibiotic Treatment for Lyme Disease 

When it comes to antibiotic treatment, there's often a debate between traditional medications and herbal remedies. While conventional Lyme disease antibiotics like doxycycline and amoxicillin are commonly prescribed, some parents may opt for herbal alternatives due to concerns about side effects or antibiotic resistance.

As a clinical psychologist of over 30 years, I encourage open communication with your healthcare provider to explore all treatment options and make informed decisions that align with your child's needs and preferences. 

Herbal remedies can offer some benefits, but like any Lyme disease medication, it's crucial to ensure they're used safely and in conjunction with conventional treatments, especially for conditions like Lyme disease, where early intervention is critical.

PANS/PANDAS, Strep and Lyme Disease Treatment

As parents, using antibiotics, both traditional and herbal, as a treatment for Lyme disease, strep, or PANS/PANDAS can be emotionally challenging. Feeling overwhelmed or anxious about your child's health and well-being is natural. 

But with the proper knowledge and support, you can confidently navigate through. Remember to consult with healthcare professionals. Weigh the pros and cons of different treatment options and prioritize your child's well-being every step of the way.

If you need support on your holistic health and healing journey, download the Natural PANS/PANDAS Calm Brain Kit. Empower your child to achieve a calm brain and a brighter future despite the challenges.

Is Lyme disease curable? 

Lyme disease is curable with antibiotics, especially when diagnosed and treated early. However, if left untreated, it can lead to more severe complications that may be challenging to treat.

Does Lyme disease go away? 

Lyme disease can typically be cured with appropriate antibiotic treatment, especially when diagnosed and treated early. However, if left untreated, it can lead to more severe complications, so timely diagnosis and management are essential.

How to treat Lyme disease? 

Lyme disease is usually treated with antibiotics, such as doxycycline, amoxicillin, or cefuroxime, depending on the stage and severity of the infection. Treatment duration can vary but typically lasts from two to four weeks for early-stage Lyme disease and may be longer for more advanced cases or complications.

Do doxycycline make you tired?

Though uncommon, doxycycline can cause fatigue as a side effect in some individuals. If you experience unusual tiredness or fatigue while taking doxycycline, it's advisable to consult your healthcare provider.

How to combat fatigue from antibiotics?  

To combat antibiotic fatigue, get enough rest and sleep while taking the medication. Additionally, staying hydrated, eating nutritious foods, and incorporating gentle exercise or movement into your routine can help alleviate fatigue.

Does joint pain from doxycycline go away?

Joint pain caused by doxycycline is typically temporary and should go away once you stop taking the medication. If joint pain persists or worsens after discontinuing doxycycline, it's essential to consult with a healthcare professional to rule out other potential causes and determine appropriate management.

How long do doxycycline stay in your system?  

Doxycycline has a half-life of approximately 18-22 hours in adults, meaning it takes that long for half of the drug to be eliminated from the body. It usually takes around five half-lives for a medication to be cleared from the system, so doxycycline may typically stay in the body for 4-5 days after the last dose.

How long does Lyme disease last?  

The duration of Lyme disease can vary depending on factors such as the infection's stage and the treatment's effectiveness. Symptoms often improve within weeks to months after starting appropriate antibiotic treatment. Still, some individuals may experience lingering symptoms or complications lasting for months or even years.

Is there a cure for Lyme disease?

While Lyme disease can typically be effectively treated with antibiotics, some individuals may experience lingering symptoms or complications. There is ongoing research into improving treatment options, but currently, there is no universally accepted cure for all cases of Lyme disease.

How do you treat Lyme disease?

Lyme disease is typically treated with antibiotics, such as doxycycline, amoxicillin, or cefuroxime, depending on the stage and severity of the infection. Treatment duration can vary but generally lasts from two to four weeks for early-stage Lyme disease and may be longer for more advanced cases or complications.

How soon do you need antibiotics after a tick bite?

Antibiotics should be started promptly if a person develops Lyme disease symptoms, such as a bullseye rash. Generally, antibiotics are most effective when started within 72 hours of the tick bite to prevent the development of Lyme disease.

What to do after a tick bite?  

After a tick bite, it's important to promptly remove it using fine-tipped tweezers, grasping it as close to the skin's surface as possible. Clean the bite area with soap and water, apply an antiseptic, and monitor for any signs of Lyme disease or other tick-borne illnesses, such as fever or rash, in the following days and weeks. If any symptoms develop, consult a healthcare professional promptly.

What kind of doctor treats Lyme disease? 

Infectious disease specialists, primary care physicians, and sometimes rheumatologists or neurologists may treat Lyme disease, depending on the infection's stage and severity and associated complications. However, it's essential to consult a healthcare provider knowledgeable about Lyme disease for accurate diagnosis and management.

Can you get Lyme disease twice? 

Yes, it's possible to get Lyme disease more than once if you're bitten by an infected tick again. Having Lyme disease once doesn't confer immunity, so individuals can contract the infection multiple times if exposed to infected ticks.

How to treat tick bite?

To treat a tick bite, promptly remove it using fine-tipped tweezers, grasping it as close to the skin's surface as possible. Clean the bite area with soap and water, apply an antiseptic, and monitor for any signs of infection or illness in the following days and weeks.

How long should you take doxycycline for a tick bite? 

The duration of doxycycline treatment for a tick bite depends on various factors, including the likelihood of Lyme disease transmission, symptoms, and the patient's medical history. If there are signs of early Lyme disease, doxycycline is typically prescribed for 10 to 21 days.

How fast do doxycycline work?

Doxycycline usually starts working within a few days of starting treatment, although improvement may vary depending on the severity and type of infection being treated. It's essential to complete the entire course of antibiotics as prescribed by a healthcare professional, even if symptoms improve before finishing the medication.

What antibiotics treat Lyme disease? 

The antibiotics commonly used to treat Lyme disease include doxycycline, amoxicillin, and cefuroxime. These antibiotics effectively eliminate the bacteria responsible for Lyme disease and are typically prescribed based on the stage and severity of the infection and the patient's medical history and allergies.

What is the strongest antibiotic for Lyme disease?

There isn't a single “strongest” antibiotic for Lyme disease, as treatment depends on various factors such as the stage and severity of the infection and patient-specific considerations. However, doxycycline is often considered effective for treating early-stage Lyme disease, while intravenous antibiotics like ceftriaxone may be used for more severe or advanced cases.

Can Lyme disease come back? 

Yes, Lyme disease can sometimes cause persistent symptoms or recurrent episodes known as “chronic Lyme disease” or “post-treatment Lyme disease syndrome.” These symptoms may recur or persist even after completing antibiotic treatment, though the exact cause and mechanisms are still under investigation.

What is chronic Lyme disease?

Chronic Lyme disease, also known as post-treatment Lyme disease syndrome, refers to persistent symptoms such as fatigue, joint pain, and cognitive difficulties that continue after completing standard antibiotic treatment for Lyme disease. There is ongoing debate within the medical community regarding the cause, diagnosis, and treatment of chronic Lyme disease.

How to stop headaches from antibiotics?  

If you're experiencing headaches from antibiotics, staying hydrated, getting enough rest, and taking over-the-counter pain relievers like acetaminophen or ibuprofen as directed by your healthcare provider may help alleviate the discomfort. However, if headaches persist or worsen, you must consult your healthcare provider to ensure no underlying complications.

Is Lyme disease bacterial or viral? 

A bacterial infection causes Lyme disease, specifically the bacterium Borrelia burgdorferi, transmitted through infected ticks' bite. A virus does not cause it.

What happens if you get Lyme disease?

If left untreated, Lyme disease can lead to various complications, including joint inflammation, neurological problems, and heart rhythm abnormalities. Early diagnosis and appropriate antibiotic treatment typically lead to a full recovery, but untreated Lyme disease can cause long-term health issues.

How long does a tick bite take to heal? 

The healing time for a tick bite can vary depending on factors such as the individual's immune response and any accompanying infection. Tick bite wounds typically heal within a few days to a few weeks. Still, it's essential to monitor for any signs of disease or illness and seek medical attention if necessary.


Di Domenico, E. G., Cavallo, I., Bordignon, V., D’Agosto, G., Pontone, M., Trento, E., Gallo, M. T., Prignano, G., Pimpinelli, F., Toma, L., & Ensoli, F. (2018). The Emerging Role of Microbial Biofilm in Lyme Neuroborreliosis. Frontiers in Neurology, 9.

Fallon, B. A., Keilp, J. G., Corbera, K. M., Petkova, E., Britton, C. B., Dwyer, E., Slavov, I., Cheng, J., Dobkin, J., Nelson, D. R., & Sackeim, H. A. (2008). A randomized, placebo-controlled trial of repeated IV antibiotic therapy for Lyme encephalopathy. Neurology, 70(13), 992–1003.

Dr. Roseann is a mental health expert in PANS/PANDAS who is frequently in the media:

Always remember… “Calm Brain, Happy Family™”

Disclaimer: This article is not intended to give health advice and it is recommended to consult with a physician before beginning any new wellness regime. *The effectiveness of diagnosis and treatment vary by patient and condition. Dr. Roseann Capanna-Hodge, LLC does not guarantee certain results.

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Dr. Roseann is a Children’s Mental Health Expert and Licensed Therapist who has been featured in/on hundreds of media outlets including The Mel Robbins Show, CBS, NBC, PIX11 NYC, Today, FORBES, CNN, The New York Times, The Washington Post, Business Insider, Women’s Day, Healthline, CNET, Parade Magazine and PARENTS. FORBES called her, “A thought leader in children’s mental health.

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She coined the terms, “Re-entry panic syndrome” and “eco-anxiety” and is a frequent contributor to media on mental health. 

Dr. Roseann Capanna-Hodge has three decades of experience in working with children, teens and their families with attention-deficit hyperactivity disorder (ADHD), autism, concussion, dyslexia and learning disability, anxiety, Obsessive Compulsive Disorder (OCD), depression and mood disorder, Lyme Disease, and PANS/PANDAS using science-backed natural mental health solutions such as supplements, magnesium, nutrition, QEEG Brain maps, neurofeedback, PEMF, psychotherapy and other non-medication approaches. 

She is the author of three bestselling books, It’s Gonna Be OK!: Proven Ways to Improve Your Child's Mental Health, The Teletherapy Toolkit, and Brain Under Attack. Dr. Roseann is known for offering a message of hope through science-endorsed methods that promote a calm brain. 

Her trademarked BrainBehaviorResetⓇ Program and It’s Gonna be OK!Ⓡ Podcast has been a cornerstone for thousands of parents facing mental health, behavioral or neurodevelopmental challenges.

She is the founder and director of The Global Institute of Children’s Mental Health, Neurotastic™Brain Formulas and Dr. Roseann Capanna-Hodge, LLC. Dr. Roseann is a Board Certified Neurofeedback (BCN) Practitioner, a Board Member of the Northeast Region Biofeedback Society (NRBS), Certified Integrative Mental Health Professional (CIMHP) and an Amen Clinic Certified Brain Health Coach.  She is also a member of The International Lyme Disease and Associated Disease Society (ILADS), The American Psychological Association (APA), Anxiety and Depression Association of America (ADAA) National Association of School Psychologists (NASP), International OCD Foundation (IOCDF).

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