Antibiotics — Dr. Rawls’ Ratings
Efficacy: 2.5 stars
Safety: 2 stars
Cost: 3 out of 5 dollar signs
Ways to Administer: oral, topical, intramuscular injections, intravenous (IV) therapy
Bottom Line: Antibiotics work well for acute infections living outside cells. But chronic infections live inside cells where they gain protection for antibiotics.


Antibiotics are synthetic chemical substances that aim to inhibit some aspect of bacteria in certain stages of their life cycles. For instance, they may disrupt bacterial replication or affect another facet of the microbe. While there’s definitely a place for using antibiotic therapy for treating acute, symptomatic Lyme disease and coinfections, there’s little consensus and available documentation on their use for chronic Lyme — specifically with people who’ve been sick for a significant amount of time and aren’t getting better.


Generally, antibiotics work well to combat extracellular microbes — microbes that live outside of other cells — like a pneumococcal infection of the lungs or when bacteria pass through the bloodstream at initial infection. Bacterial growth rate is the key. During the acute phase of an infection, bacteria grow more rapidly than other microorganisms in the body, and therefore, antibiotics knock down their numbers rapidly, without adversely affecting the microbiome (normal flora) in the gut and on the skin. In contrast, once the bacteria distribute to tissues throughout the body, they invade cells, which makes them more resistant to antibiotics. This is a fundamental characteristic of all the Lyme microbes: borrelia and coinfections like bartonella, babesia, and mycoplasma are intracellular, meaning they can live inside cells, where they grow slowly and gain protection from antibiotics. Although antibiotics may be helpful for some people, they’re not my first choice for chronic infections.


The use of antibiotics to target chronic, intracellular infections often requires months, even years, of treatment, which destroys your normal gut flora and further disrupts your immune system, leading to significant safety concerns like candida overgrowth or the diarrhea-causing Clostridium difficile (C. diff).


The cost of antibiotics will vary depending on your insurance coverage and the length of time you take them. With long-term use, many patients will accrue substantial out-of-pocket expenses — sometimes totaling tens of thousands of dollars.

Dr. Bill Rawls Treatment Guide

Dr. Bill Rawls’ Treatment Guide

Want to see more Lyme disease treatment ratings? See What Dr. Rawls has to say about popular treatments and therapies in his Lyme Disease Treatment Guide.

Dr. Rawls is a physician who overcame Lyme disease through natural herbal therapy. You can learn more about Lyme disease in Dr. Rawls’ new best selling book, Unlocking Lyme.
You can also learn about Dr. Rawls’ personal journey in overcoming Lyme disease and fibromyalgia in his popular blog post, My Chronic Lyme Journey.

1. Gwynne PJ, Gallagher MP. Light as a Broad-Spectrum Antimicrobial. Front Microbiol. 2018;9:119. Published 2018 Feb 2. doi: 10.3389/fmicb.2018.00119