This is one of those open questions where we need more high quality research. In my opinion (not as a doctor) patients usually start with 2 or 3 antibiotics and see how they do for a couple weeks at half strength. If there are no issues, another antibiotic is added or the others are ramped up. Anecdotally, it is sometimes at the ramp up period where people experience a return of CD symptoms or die off (they can be similar so it's hard to tell). Docs can then work with patients to drop one antibiotic to try to figure out which one is the issue if symptoms are very severe.
Also, some people will either have an allergic reaction to one antibiotic, which then needs to be discontinued. A couple of our community members have had a severe reaction to AMAT and they have also mentioned they are generally "sensitive" to medication. For this group, they may only need a half strength dose.
In my own case, I had pretty severe nausea that I'm guessing was caused by the clarithromycin. I almost could not keep it down. This went on for a couple of weeks and then I started to get better. It felt like I was in a terrible CD flare. My doctor told me to watch for symptoms of obstructions and CDiff, but as long as I could tolerate it and take it easy, to continue on the protocol because hopefully my symptoms were due to die off. I should also mention I started on a full strength regimen on Day 1 (1000mg clarithromycin, 600mg rifampin and 500mg levofloxicin.) Levo is not commonly used for AMAT anymore due to the FDA warning about fluoroquinolines.
Dr. Chamberlin answered some general AMAT questions a couple of years ago which may also be helpful:
https://humanpara.org/anti-map-qa/The key is to keep in touch with your prescribing doc as you go through the first couple months and bring up any concerning symptoms.
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Topic: AMAT Protocol and Adverse Effects (Read 11257 times)