Wednesday, December 2, 2015

Lyme antibiotics revisited

There are a surprising number of drugs, many of which are not antibiotics, which have anti-lyme/anti-persister effects. An additional 113 agents are presented by Zhang in the latest article published in “antibiotics” September, 2015. Some of these drugs are in common use, amongst Lyme patients – but to treat something else. The list includes antibiotics, antivirals, antifungals, anthelminthics and antiparasitics. Other, unexpected agents are in the list include an arcane antidepressant. Of course daptomycin heads the list. Drugs already in common use include: artemisinin (very effective), Diflucan-fluconazole (very effective) and rifamycin related agents. The latter two from this list are referred to as active hits. Other less active hits include some quinolones (not in clinical use) and a limited list of cell wall agents, available, but also not generally used. Rifampin (rifamycin) is of greater interest to me. My grasp of this drug has evolved. ALS (Advanced Laboratory Services) adds rifampin to culture medium to cultivate Borrelia. This might lead one to conclude that rifampin does not kill Lyme. Studies show that Rifampin kills persister forms of Lyme, not spirochetes: makes sense. Lyme is rarely found in blood. The few free swimmers are referred to as planktonic. These are motile spirochete forms. Spirochete forms are not killed by Rifampin and therefore can be cultured in a medium containing rifampin.  The antipersister properties of rifampin are well known for the treatment of tuberculosis which requires the use of 4 antibiotics over a period of many months.
A new study published in “Nature” Lehar et al, discuses a novel approach for the treatment of Staph aureus. The study states that Staph bacteria hide inside cells, a protected milieu. (Mouse model). Staph aureus survive within phagocytic macrophages (the cells which “eat” and eliminate offending pathogens). The S. aureus were found to spread via a Trojan horse mechanism, a mechanism also employed by Lyme. The most potent anti-Staph aureus, MRSA antibiotics, vancomycin and daptomycin were unable to eradicate intracellular MRSA staph. In the mouse, intracellular infection allowed widespread invasion into many organs, including the brain. Not good.
These researchers took a fresh approach to killing S. aureus. The idea was to clone antibodies against S. aueus, find the best antibody and link it to an antibiotic creating a new molecule, an “antibody-antibiotic conjugate.
The antibiotic chosen for the project was neither vancomycin nor daptomycin. The drug was from the rifamycin class of antibiotics. Compared with vancomycin and daptomycin the minimal inhibitory concentration of the rifampin-like drug, intracellular and extracellular, was infinitely (slight exaggeration) better than the other two drugs. The second best drug studied was a forth agent, linezolid by the way. The rifamycin class of antibiotics were praised for: high potency, unaltered bactericidal activity in low phagosomal pH and an ability to withstand intracellular insults.
This new “AAC” compound was more effective than all other agents and able to clear the S. aureus in the mouse, including organisms hiding inside the intracellular niche. This new class of drug will not be available for human use, if it pans out, for a good 10 years or more.
I will not say exactly how I treat patients (which varies quite a bit), but...
The news about rifampin and related drugs is good. Perhaps with antibodies already present in our system we can hope for a similar result. The new compound is made of a rifampin-liked drug linked to a specific antibody.  
I have long thought that rifampin was essential for treating Bartonella. Maybe this is wrong. Maybe the extra Herx that occurs with the addition of Rifampin because is due to killing a variety of pathogens living within cells, perhaps including Lyme and Staph for all we know.
The paradigm of treating Lyme is expanding and becoming more complex. An understanding of the pharmacology of individual drugs, synergistic properties, tissue penetration and many other factors must be understood by an experienced clinician in the formulation of effective drug cocktails. Individual responses to drugs are quite variable. There is not a one size fits all approach that is consistently effective.

1 comment:

O. said...

Wanted to share some of Dr. Klinghardt MD PhD comments from a 2014 Lyme meeting in relation to treating parasites for Lyme:

Treating parasites in many different ways leads to the rope parasite coming out. He calls it the rope parasite rather than the rope worm as it is still not clear exactly what "the creature" is. When these start coming out, Lyme patients improve and feel better.
Clinical symptoms with Lyme is much closer linked to rope parasites than anything else.
Most recovered, asymptomatic Lyme patients still test highly positive for Lyme on the Western Blot, LTT, and culture test. Lyme may be the underlying cause of the illness, but it is not the cause of the symptoms.
The rope parasite is likely a biofilm community of different organisms that live together in a meaningful way. The "rope worm" is not falling into the classic definition of a parasite but more of a biofilm.
Probiotic enemas with Bifidus may be helpful. 
There is no reliable lab for parasites. Dr. Klinghardt has never had a patient with a positive Western Blot for Lyme that did not have parasites.
Raw food diets are a major reason people have parasites. In one study of salad bars in New York, almost all of them had parasite eggs.
For lung worm, various approaches include inhalation of ETOH, iodine, or ASEA have been helpful. The lung worm does not generally create significant symptoms but leads to chronically low oxygen in the blood. Biltricide may be helpful.
We feed parasites and they extract toxins from us. Lead levels in the host and a parasite were compared and found to be 106 times higher in the parasite; cadmium 119 times higher.
The rope parasite may be an adaptive mechanism to survive the time we are in.
Aluminum fosters the growth of microbial pathogens and parasites. Aluminum is probably the main cause of parasites and Lyme disease.
A rope parasite was shown to have 228 times more aluminum than the host; 72 times more lead; 62 times more zinc, and 94 times more magnesium.
Treatment includes: 1) Stopping foods, behaviors, and supplements such as B vitamins that feed the parasites, 2) Heavy metal detoxification and mineral replacement, 3) Enema and/or Suppository protocols regularly for 18 months, and 4) Repeated oral anti-helminthics. Some of the oral options include liposomal artemisinin, Curcusyn (curcumin and ginger), Mimosa pudica, Chaga, freeze-dried garlic, Albenza, Ivermetctin, Alinia, and others. Ginger is a great anti-parasitic and covers things with no other RX options.
Chaga is great for Bartonella, Borrelia, Mycoplasma, and parasites. American Chaga is a different fungus from the Siberian Chaga. Chaga has to be started with a sprinkle and slowing increased. It is the most powerful single compound for Lyme in the past few years.
Freeze dried garlic is a good option for H. Pylori, Bartonella, Clostridia, molds, fungi, HHV-6, and even HIV. Allicin has a half-life of 10 days. Freeze dried garlic continues to work as it has all of the compounds in it.
Aluminum is necessary for the Lyme bugs to penetrate the blood-brain barrier. We need to look at sources of aluminum but also need to work a detoxification program. Getting worms out whole via rectal anti-parasitic treatments is an excellent way to detoxify. 
Parasites do not like pulsed fields such as PEMF. They decrease the parasites ability to replicate.
There is a set of patented Gubarev enema protocols.
Chronic illness has been linked with the count of anaerobic organisms.
When parasites are metal-enriched, they cannot be eliminated by the immune system. 
TNF-a, TGF-b, IL-6, hs-CRP all go up with parasites. 
Parasite treatment requires work from both ends and radical toxin elimination.
With treatment, cholesterol goes down, insulin resistance goes down, and hormones balance. People improve when getting out the rope parasite.
Lyme, co-infections, mold, auto-immunity, food allergies, CFIDS, MCS, colon/liver/pancreatic cancers are all CONSEQUENCES of parasites; not the cause of the illness.
Initially assume that every illness you see is caused by parasites.