Dr. Amir Khadir defends prolonged antibiotic treatments after six-month suspension

Amir Khadir, then provincial MNA for Québec solidaire, surrounded by his wife Nima Machouf, during a press conference on Friday, May 4, 2018, in Montreal. (The Canadian Press/Paul Chiasson)

Former Québec solidaire MNA Dr. Amir Khadir says he does not regret treating his patients with Lyme disease using prolonged courses of antibiotics.

Khadir is considering legal action with his lawyer in an effort to reduce the six-month suspension issued Wednesday by the disciplinary council of the Quebec College of Physicians.

Khadir wants to appeal the council’s decision, saying he is seeking a one-month suspension instead of six. He did not give further details, noting that his lawyer is out of the country this week.

Khadir pleaded guilty to all 12 counts in the complaint filed on the first day of the hearing before the disciplinary council on Oct. 28. No complaints were filed by Khadir’s patients.

He was joined by a group of people living with long COVID during a news conference Thursday in Montreal.

These patients say they are concerned about his suspension because he is one of the few physicians in Quebec who treats people with long COVID. The wait-list for this kind of care often exceeds two years.

Family physician Caroline Grégoire knows this firsthand. She has been living with long COVID since 2020 and also has myalgic encephalomyelitis.

“In Quebec, despite the scale of the issue, access to specialized care remains extremely limited,” she said. “The number of doctors with real clinical expertise in long COVID can be counted on one hand. Among them, Dr. Khadir plays a vital role.”

Grégoire said a doctor with this expertise in the Sherbrooke region is about to retire.

In the Quebec City area, another physician reportedly has a wait-list of more than two years.

“This scarcity of expertise leaves thousands of people without a clear care pathway and without proper clinical support. And this gap in the system — this lack of human resources and structure — is something we feel very acutely every day,” Grégoire said.

At the news conference, the Quebec Lyme Disease Association (AQML) defended Dr. Khadir.

The group said many of the patients he treated were followed by the AQML and reported real improvement, sometimes a return to an almost normal life.

The AQML made several requests to the health minister. It wants him to ensure real access to care for people with Lyme disease; to encourage an approach based on shared, informed medical decision-making when options are limited or slow to emerge; to put in place the frameworks needed to support research; and to allow patients access to clinical trials.

‘Of course I don’t regret it’

Asked whether he regretted prescribing antibiotics for more than 28 days despite a 2020 agreement with the CMQ to stop doing so, Khadir said: “Of course I don’t regret it.”

He stressed that he did not provide experimental treatments. “I can’t regret something that is based on science,” he said.

Khadir said his approach was part of an informed decision made by his patients “taking into account the limits of what we know, the scientific gaps, and weighing the benefits and risks.”

According to his account, patients come to him after undergoing exhaustive testing for various diagnoses. They are often “at the end of their rope” and “out of financial resources,” he said.

Typically, when patients consult him, they are “on lifetime pills that leave them completely zoned out and unable to function,” he said, because no other treatments are available.

“In those conditions, imagine what the patient’s informed decision looks like,” he said. “Instead of living a life that’s vinegar and being zoned out doing nothing, watching myself sink, I’m going to take the risk of maybe having a bit of diarrhea, a bit of cramping,” he said, referring to symptoms associated with prolonged antibiotic use.

For him, it is a “misconception” to assume that the impacts of long-term antibiotic use are greater than the benefits for the patient. “Completely — but completely — wrong assumptions,” he said.

The 2020 agreement to stop using this treatment was meant to end once a formal research protocol on prolonged antibiotic therapy for chronic Lyme disease was established.

“What I regret is not having set priorities, not having created the research framework so that these problems wouldn’t have happened,” he said.

“But fortunately for us, science now shows that all options are open. I’ll repeat it a fifth time, including [providing] prolonged antibiotics for patients in whom we strongly suspect that bacterial persistence is causing symptoms. Will all patients respond? No. But in any chronic illness, if you have a treatment that helps even a third of patients, that’s a significant success,” the microbiologist and infectious disease specialist said.

“That said,” he continued, “antibiotics, of course, if you give too much, and especially if it’s not useful, are toxic. Anything that isn’t useful is poison. So it’s always a matter of weighing risk and benefit.”

He reiterated that he does not intend to resume this treatment unless he obtains all required authorizations.

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- This report by The Canadian Press was first published in French on Dec. 4, 2025.