Hi @justy,How can we really tell if it is an adverse drug reaction or a herx?
generally speaking one can be sure of a herx only after the end of the course if and when there's been some improvement compared to before. As a rule of thumb herx reactions can take a few days to kick in. Burrascano in his Lyme guidelines says (if I remember this right) of at least three days of continuous bacterial killing. In my case when it happened it would happen from around day four or five. If you had such a quick reaction I would consider it a hypersensitivity reaction.
It's a shame Rifampin is a very effective abx which I took for some time (together with Minocycline and at some point zithromax) as it can act simultaneously against CPn, Bartonella and Lyme and many other often resistant infections. But there are good alternatives such as those your dr has come up with and as treatment progresses and recovery starts, we can also overcome sensitivities . Best wishes.