-
- Note - We suggest you print this out and take it to your
physician or medical care provider.
-
-
- Mycoplasma Information Package
By Sharon Briggs SHASTA CFIDS, California USA
- 8-18-00
-
-
- The curse of Gulf War Vets, and now purportedly those
suffering from chemtrail sicknesses.
-
- While it is still not known what causes CFS, FMS, and
MCS, we are hearing of reports that a very high number (75-80%) test positive
for a pathogenic form of the organism called Mycoplasma. While there are
several species of this organism, most of us have been found to have active
infections in our bodies of the Mycoplasma fermentans (incognitus), Mycoplasma
penetrans, and Mycoplasma pneumoniae types. These organisms are a pathogenic
form of Mycoplasma which are very slow-growing, invasive into deeper parts
of the body (i.e., brain, central and peripheral nervous system, muscles
and joints, bone marrow, gastrointestinal system, lungs and heart, and
the immune system, itself), and are very difficult to treat. These are
the same organisms that have been found in AIDS patients and Gulf War Syndrome
patients.
-
- Those who test positive for active infection with a Mycoplasma
are realizing a tremendous improvement &/or recovery in their health
with appropriate antibiotic treatment. This treatment is long term (1-2
years of continuous antibiotics). The initial segment of the treatment
can be difficult and the continuous antibiotic dose is very harsh on the
body.
-
- Many people with CFIDS are concerned (and some are even
frightened) to take antibiotics for prolonged periods of time. However,
years of medical experience in the use of antibiotics to treat chronic
infectious conditions such as rheumatic fever, acne, recurrent ear infections,
Chronic Obstructive Pulmonary Disease, bronchiectasis, and others, have
not revealed any consistent dire consequences as a result of such medications.
-
- Indeed, the very real consequences of untreated, chronic
persistent infection with Mycoplasma can be far worse than the potential
consequences of this treatment. If you begin treatment, it is recommended
that you be monitored closely by a knowledgeable physician. If your physician
is not familiar with long-term antibiotic therapy, or if he/she is unsure
of the pathophysiology of the Mycoplasmas, they are invited to call Dr.'s
Garth or Nancy Nicolson (see Resource List).
-
- Since this form of treatment is so new for CFS, FMS and
MCS, we are all involved in research of a sort. Because of that, we need
to keep in touch and share triumphs and problems encountered. And, as we
get well, we need to spread the word and help others. If you test positive
for the organism, please send the enclosed form to the Mycoplasma Registry
(see Resource List). The Mycoplasma Registry is a non-profit organization
set up to track those who test positive. They have over 800 in the registry
thus far, and have compiled some excellent statistics. Approximately 85%
of those in the registry listing come from the CFS, FMS and MCS community!
Of course, all listings are confidential. Also, feel free to copy and share
any of the papers in this Mycoplasma Packet with others.
-
- We are all-different, and will undoubtedly respond differently
to the treatment. As with any treatment suggestions given, the information
in this packet is intended to help you make informed decisions about your
care. It is not intended to take the place of medical advice. Please work
closely with your physician to tailor any treatment to your individual
needs and differences.
-
- Enclosed in this packet are the following:
- 1. Mycoplasma: A Simple Overview, written by Sharon Briggs
- 2. Antibiotics Recommended When Indicated for Treatment
of Gulf War
- Illness/CFIDS, written by Garth Nicolson, Ph.D.
- 3. Additional Considerations When Undergoing Treatment
For GWI/CFS/FMS,
- written by Garth Nicholson, Ph. D.
- 4. Mycoplasma Treatment Suggestions, written by Sharon
Briggs
- 5. An Overview of My Symptoms and Recovery from CFIDS
With Antibiotics,
- written by Sharon Briggs
- 6. Mycoplasma Resource List
- 7. Mycoplasma Registry Form
- 8. Institute for Molecular Medicine, Blood Test Order
and Information Form
-
- Any donations to offset the cost and postage of this
packet would be
- greatly appreciated.
-
- Sharon Briggs
- Support Group Leader
-
- MYCOPLASMA: A SIMPLE OVERVIEW
-
- For years we in the CFS/FMS/MCS community have been watching
the reports of Gulf War Illness (GWI) knowing, instinctively, that we all
had something in common. Not only do we all have common symptoms, but we
may also be infected with common pathogenic organisms. That pathogen is
a Mycoplasma. Various pathogenic strains have been identified including
the fermentans (incognitus), penetrans, genitalium, hominis, and pneumoniae.
And, we may be infected with several of these strains at one time. Following
is a simple overview of the information I have gathered about this Mycoplasma
pathogen and how it affects us.
-
- How Was Mycoplasma Infection Identified In GWS and CFIDS
Patients?
-
- The information trail started with Garth and Nancy Nicolson.
Their daughter returned from the Gulf War with an unexplained illness.
She was unable to continue her studies at college, and moved back home.
Soon after, her parents both became ill with the same symptoms. Medical
tests revealed nothing abnormal, but they all continued to worsen. Fortunately
for them, however, the Nicolson's were molecular pathologists with an entire
research laboratory at their disposal. The Nicolson's drew blood and tissue
samples from themselves and their daughter, and set the research team,
to work.
-
- Garth Nicolson Ph.D. is a professor and former chairman
of the Department of Tumor Biology at the University of Texas, M.D. Anderson
Cancer Center, Houston, TX. He is also a professor of Internal Medicine,
Pathology and Laboratory Medicine at the University of Texas Medical School.
He has published over 500 scientific and medical papers, has edited 13
books, he is the current editor of two scientific and medical journals.
Dr. Nicolson has been nominated for the Nobel Prize in cell microbiology,
is among the 100 most cited researchers in the world, and sits on the board
of the American Association of Cancer Research. Nancy Nicolson, Ph.D. was
president of the Rhodon Foundation for Biomedical Research. She, also,
has published numerous scientific papers and was a professor in the Department
of Immunology and Microbiology at Baylor College of Medicine.
-
- What they found was a living Mycoplasma pathogen. In
order to find this organism, they had to break open the leukocytes (white
blood cells), and perform a specific test called a Polymerase Chain Reaction
(PCR) of the DNA of the organism. Nancy also perfected another test, called
Gene Tracking, which confirms the PCR results. To gather more information,
they then started testing other GWI patients. What they found was that
approximately 50% were positive for the live organism. The Nicolson's then
researched treatment options and found a number of antibiotics that were
effective against the organism. (2) After a lengthy course of antibiotics,
they recovered. But, the word was out, and requests for testing of GWI
patients kept coming in to the lab. They were inundated! As their evidence
mounted, they published their data (3) (4) (5) and testified before the
President's Panel on Gulf War Illnesses. (6) Then the connection was made
by the government of the similarities between GWI and CFIDS. (7) By this
time, the Nicolson's lab was already running tests of those with CFIDS---with
the same results-- approximately 50% positive! Garth and Nancy Nicolson
even wrote an article for the CFIDS Chronicle outlining the diagnosis and
treatment of GWI/CFIDS. (8)
-
- But, the politics of medicine and research have slowed
the gears of progress! Garth and Nancy had to relocate their non-profit
lab (The Institute for Molecular Medicine), first to Irvine, CA, then to
Huntington Beach, CA. They have had difficulty finding funding for the
Mycoplasma research. For their research to continue with CFIDS testing,
they need a new grant. In the meantime, they have formed a non-profit organization
and take tax deductible donations, and they are making plans to take third-party
billing in order to bill insurance for part of the cost of the tests. Presently,
one can become a "Friend of the Institute" and have the various
tests done at The Institute for Molecular Biology lab, as well as, participate
in the research (see Resource List for full instructions).
-
- Those of us who have tested positive and have begun treatment
with the antibiotics recommended by the Nicolson's have had tremendous
success. Some of these people have been ill with CFS/FMS/MCS for 15-20
years. But, they are feeling better for the first time since becoming ill!
Some have even returned to work. Many have completed several months of
antibiotics, and several have been taking them continuously for 1- to 2
years. Since most of us in the CFS/FMS/MCS community have been ill with
this organism for a lot longer than the GWI patients do, it may take longer
to successfully treat the infection.
-
- What Is Mycoplasma?
-
- Mycoplasmas are the smallest and simplest organism known.
They are not new. They were discovered over 100 years ago and evolved from
bacteria. The "garden variety" mycoplasma is not usually associated
with severe diseases. (13) However, sometime over the past 30 years, the
organism has been altered to become more lethal. The Mycoplasmas found
by the Nicolson's, in their lab, contain unusual gene sequences that were
probably inserted into the Mycoplasma by a specific laboratory procedure.
This discovery has led them to conclude that the new forms of mycoplasma
were specifically engineered for germ warfare. (9) In it's laboratory evolution,
the Mycoplasmas have became more invasive, more difficult to find, and
capable of causing severe diseases in humans. Diseases, like Gulf War Illness,
CFS, FMS, MCS, Rheumatoid Arthritis, and AIDS, for instance.
-
- The earlier form of Mycoplasma was studied by Dr. Shyh
Lo, formerly of Tanox Biosystems, a spin-off biotechnology company from
the Baylor College of Medicine, but now affiliated with the Armed Forces
Institute of Pathology in Washington D.C. Dr. Lo has been credited with
discovering the new pathogenic form of Mycoplasmas, and he currently holds
several patents on methods for special handling of the organisms for study
and development. (10) In one of his patents (in 1991), Dr. Lo lists the
following diseases that are caused by Mycoplasma: HIV infection, AIDS,
Aids Related Complex (ARC), Chronic Fatigue Syndrome, Wegener's Disease,
Sarcoidosis, Respiratory Distress Syndrome, Kibuchi's Disease, Alzheimer's
Disease, and Lupus. (10) In addition, Baseman and Tully have reviewed the
literature on the role of Mycoplasmal infections in human disease and have
concluded that they are important factors or co-factors in a variety of
chronic illnesses. (11)
-
- Unlike bacteria, the Mycoplasma has no cell wall. This
enables it to invade tissue cells, incorporating the cell's nutrients,
and using the cell to replicate itself (much like a retrovirus). (13) When
the Mycoplasma breaks out of the cell, it takes a piece of the host cell
membrane with it. When the immune system attacks the Mycoplasma, it also
gets "turned on" to attacking the host cell. In this way, an
autoimmune condition can begin. Autoimmune conditions associated with Mycoplasmas
include arthritis, fibromyalgia, myositis, thyroid dysfunction (Hashimoto's
or Grave's Diseases), and adrenal dysfunction, signs and symptoms of Lupus,
Multiple Sclerosis, Lou Gehrig's Disease. (12)
-
- The Mycoplasma organism has the capacity to invade cells,
tissues and blood, producing systemic infections in numerous organ systems.
According to Dr. Nicholson, it can penetrate the central and peripheral
nervous system. Because it has the ability to damage the immune system
by invading the natural killer cells (NK cells) of the lymphocytes, it
weakens them, reduces their numbers, and renders them susceptible to viral
infections, such as Human Herpes Virus 6 (HHV6). (14) (15) (16) It may
also explain some of the environmentally sensitive responses that are seen
with CFIDS and MCS.
-
- Mycoplasma infection can trigger inflammatory cytokine
over-production that is commonly seen in CFS/FMS. With the induction of
CD-4+ helper cells of the immune system, an over production of cytokines
such as Interleukin-1, Interleukin-6 and Tumor Necrosis Factor-alpha occurs.
(15)(16)(17) These elevated cytokines have been implicated in the development
of many of the CFS/FMS symptoms, including neurological involvement. (19)(20)
They can have specific or nonspecific stimulatory or suppressive effects
on lymphocytes, as measured by B and T cell activation. (18) In addition,
the Mycoplasma infection has immunomodulating effects, activating the hypothalmic-pituitary-adrenal
axis. This can cause a cascade of limbic system symptoms characteristic
of CFS/FMS. (19)
-
- The Mycoplasma is a slow-growing, stealth-type organism
that can cause the patient to be very ill. It activates the immune system,
then can successfully hide from it within the host immune cells. It can
then circulate throughout the body and go wherever a white blood cell can
go. It can cause infection deep within any or all organs. It can even cross
the blood/brain barrier and cause brain and spinal infection. It has also
been known to cross the placental barrier to an unborn fetus. Unless the
white blood cell is split open and examined for the evidence of the live
organism, it can go undetected for years. Because the organism resides
deep within the cells, conventional antibody tests may be relatively useless.
(21) The splitting open (fraction) of leukocytes (white blood cells) from
a fresh blood sample, with a forensic PCR test is the most accurate way
to detect the presence of active infection with a live pathogen. Further
gene-tracking techniques perfected by the Nicolson's are even more accurate.
(22)
-
- Contagion
-
- Although the researchers have not clearly established
how contagious the Mycoplasmas are, they have made some inferences from
the data they have collected. The Mycoplasma organism has been found in
the blood and body fluids, spinal fluid, bone marrow, urine, and in the
lungs, nose and mouth. The Mycoplasma is reported to be able to survive
for two hours outside the body. Of those with Gulf War Illness, 50% of
their spouses have contracted the disease and 100% of their children. Several
babies have also been known to be born with the disease. Some sort of chemical
exposure or immune distress (i.e., auto accident, surgery, cancer) appears
to pre-date the onset of illness. Of those with CFS, FMS, and MCS, numerous
friends and spouses have the illness, as well as close relatives. So, from
the anecdotal reports, it would appear that Mycoplasma is contagious after
both casual and intimate contact. This means that the organism may possibly
be passed to another through sputum (coughing droplets that contain the
organism), saliva, sexual secretions, blood, and urine. The disease is
also developing in family pets.
-
- If one test positive for any of the Mycoplasmas, in order
to safeguard those with whom you have close contact, it would be prudent
to do the following: Wash your hands a lot, never share your food or drink
with another, wash eating utensils with extremely hot water, keep your
hands away from your face, avoid closed-air spaces where air is re-circulated
(i.e., offices, airplanes), and use protective sexual practices.
-
- Treatment
-
- If detected early, the diseases associated with invasive
mycoplasmal infections are treatable with long cycles of high-dose antibiotics.
(23)(24)(25) Since the organism is a slow-growing, intracellular type with
a long life cycle, several, long term courses of antibiotics may be necessary.
The infection may need to be treated for several months or years. (The
disease is treated much as Lyme's Disease is treated.) If a person is taking
antibiotics, the testing will not detect the presence of Mycoplasma in
the blood. And, if a person has been taking antibiotics, they must wait
for 2-3 months after stopping the antibiotics for the test to be accurate.
-
- As yet, we do not know if antibiotics are a cure for
Mycoplasma infections. Mycoplasma fermentans (incognitus) has the ability
to enter any cell and alter itself, changing its cellular makeup with every
cell division. This may make it impossible for readily available antibiotics
to clear the body of this organism. (14)
-
- What we are hoping for is to cause the organism to be
diminished or go dormant until a cure is discovered. To do that, we need
to kill as much of the live organisms from our bodies as possible with
the antibiotics. Once our white blood cells are free of the infection,
then they can become healthier and can, hopefully, do a better job to keep
the Mycoplasma under control. This may take several months/years of antibiotic
treatment to accomplish. During this time, it is important to not lower
the dose or stop taking the antibiotic too early, for a relapse is certain.
-
- Is Treating Mycoplasma Infection The Answer To Curing
CFIDS?
-
- The precise nature and cause of CFS/FMS/MCS is not clear
at this time. However, recent studies have shown that several microorganisms
may be a factor in CFIDS. Clinical PCR testing has been positive for all
of the human herpes viruses, particularly Epstein-Barr Virus (EBV) and
Human Herpes Virus-6, Types A and B (HHV-6). Most recently, organisms like
Human T-lymphotropic virus (HTLV) types I and II, the foamy or Spuma virus,
and the Chlamydia pneumoniae bacteria have also been demonstrated. (26)
-
- Perhaps with this evidence, it would appear that CFIDS
has many causative organisms? That is a possibility. Researchers studying
AIDS have found that Mycoplasma and HHV-6a may be co-factors for causing
AIDS. (14) And, it is further speculated that this same HHV-6 virus may
be a co-factor in CFIDS and Multiple Sclerosis. Dr.'s Konnie Knox and Donald
Carrigan from the Greenfield, Wisconsin Laboratory (see Resource List),
offer some of the most sophisticated human herpes assays in the world.
They have been doing extensive research into the various forms of human
herpes and their effects on the body. Present in about 98% of the population,
HHV-6 remains dormant and harmless in healthy people. But, when activated
(possibly by the Mycoplasma infection), it can cause a highly dysregulated
immune system often resulting in severe immune suppression which increases
an individuals vulnerability to control severe infections (such as Mycoplasma).
Perhaps, if HHV-6 were a co-factor of our disease (along with Mycoplasma),
it would appear to be best to be tested and treated for both concurrently,
if one is found to be positive.
-
- While the researchers sort out the chicken-or-the-egg,
one-organism-one disease, multi-factor theories, it seems prudent for us
to test for and consider treating the organisms that we can. Especially
when, in the case of Mycoplasma, a few simple antibiotics can bring us
so much relief! In the case of a positive test for HHV-6, the antiviral
Zovirax may be helpful, and the FDA will soon release a new drug, called
Labucavir that may be effective against the Human Herpes Virus family,
specifically. However, it is still in the testing phase and is not yet
available.
-
- Conclusion
-
- Infection with a Mycoplasma organism appears to cause
most of the signs and symptoms of CFS/FMS/MCS. It can also account for
most of the dysregulation of the immune system and the abnormal immune
tests. It seems prudent to be tested for this organism, and if positive,
to be treated with the recommended antibiotics. Many of us have been ill
for 10-20 years and have spent thousands of dollars on treatments that
did nothing. Wouldn't it be a Godsend to have a treatment that worked?
-
- The treatment course is long term and often difficult
for many. And, while we may not become completely well, there is preliminary
evidence that many of us who are taking the antibiotics are improving!
It has certainly been a horrible disease for the Gulf War Vets to contract,
but for us, the fact that they did has saved many lives in the CFS/FMS/MCS
community!
-
- References
-
- 1. Nicolson, N.L. and Nicolson, G.L., The Isolation,
Purification and
- Analysis of Specific Gene-containing Nucleoproteins and
Nucleoprotein
- Complexes, Methods of Molecular Genetics, 5:281-298 (1994)
-
- 2. . Nicolson, Garth L., Antibiotics Recommended When
Indicated for
- Treatment of Gulf War Illness/CFIDS, (1996)
-
- 3. Nicolson, G.L., and Nicolson, N.L., Chronic Illness
of Operation Desert
- Storm: The Presence of Stealth Microorganisms in Gulf
War Veteran's Blood
- Suggests that Biological Warfare May Have Been Used In
Desert Storm,
- Extraordinary Science, (1995)
-
- 4. Nicolson, G.L., Hyman, E., Korenyi-Both, A., Lopez,
D.A., Nicolson,
- N.L., Rea, W., and Urnovitz, H., Progress on Persian
Gulf War
- Illness-Reality and Hypotheses, International Journal
of Occupational
- Medicine and Toxicology, Vol. 4, No.3, pp. 365-370, (1995)
-
- 5. Nicolson, G.L., and Nicolson, N.L., Diagnosis and
Treatment of
- Mycoplasmal Infections in Persian Gulf War IllnessóCFIDS
Patients,
- International Journal of Occupational Medical Immunology
and Toxicology, 5:
- 69-78 and 83-86, (1996)
-
- 6. Nicolson, Garth L & Nicolson, Nancy L., Mycoplasma
Infections In Gulf
- War Illness: Results of a Preliminary Study on the Prevalence
of
- Mycoplasmal Infections in Desert Storm Veterans with
Chronic Fatigue and
- other Symptoms, Presented to the President's Panel on
Gulf War Syndrome,
- Washington, DC, August 14-16, (1995)
-
- 7. Schmidt, P., Blanck, R.M., Gulf War Syndrome and CFS,
The CFIDS
- Chronicle, 8:25-27 (1995)
-
- 8. Nicolson, G.L. and Nicolson, N.L., Mycoplasma Infections-Diagnosis
and
- Treatment of Gulf War Illness/CFIDS, CFIDS Chronicle,
9 (3): 66-69, (1996)
-
- 9. Nicolson, Garth L., Ph.D. and Nicolson, Nancy L..,
Ph.D., Summary Of
- Persian Gulf War Illness Pilot Study On Mycoplasmal Infections
In Veterans
- and Family Members, 1997
-
- 10. Lo, Shyh-Ching, Patent # 5215914: Adherent and Invasive
Mycoplasma,
- Patent # 5534413: Adherent and Invasive Mycoplasma, Patent
# 5242820:
- Pathogenic Mycoplasma, Patent #5532134: Mycoplasma Diagnostic
Assay, IBM
- Patent Server Database
-
- 11. Baseman, J. and Tully, J, Mycoplasmas: Sophisticated,
Reemerging, and
- Burdened by their Notoriety, Emerging Infectious Diseases,
1997; 3:21-32
-
- 12. Nicolson, Garth L. Chronic Infections In CFS, FMS
and Gulf War Illness,
- 1997
-
- 13. "Archives of Pathological Laboratory Medicine",
May, (1993)
-
- 14. Montagnier, L., HIV, Cofactors and AIDS, Abstract
from the
- International Conference on AIDS, June 6-11 (1993)
-
- 15. Rawadi, G., Roman-Roman, S, et.al., Effects of Mycoplasma
fermentans on
- the Myelomonocytic Lineage: Different Molecular Entities
with
- Cytokine-inducing and Cytocidal Potential, Journal of
Immunology, Jan. 15
- (1996)
-
- 16. Gallily, R., Salman, M., Tarshis, M., Rottem, S.,
Mycoplasma fermentans
- (incognitus strain) Induces TNF alpha and IL-1 Production
by Human
- Monocytes and Murine Macrophages, Immunological Letters,
34(1):27-30 Sept.
- (1992)
-
- 17. Brenner, T., Yamin, A., Abramsky, O., and Gallily,
R., Stimulation of
- Tumor Necrosis Factor-alpha Production by Mycoplasma
and Inhibition by
- Dexamethasone in Cultured Astrocytes, Brain Research,
608(2):273-79 Apr. 16
- (1993)
-
- 18. Haier, Joerg, M.D., Nasralla, Marwan, and Nicolson,
Garth L.,
- Mycoplasmal Infections in Blood from Patients with Chronic
Fatigue
- Syndrome, Fibromyalgia Syndrome or Gulf War Illness,
Abstract from the
- International CFS Congress, Sydney, Australia, 1998
-
- 19. Brenner, T., Yamin, A., and Gallily, R., Mycoplasma
Triggering of
- Nitric Oxide Production by Central Nervous System Glial
Cells and its
- Inhibition by Glucocorticoids, Brain Research, 641(1):51-56
Mar. 28 (1994)
-
- 20. Weidenfeld, J., Wohlman, A., and Gallily, R., Neuroreport
6(6):910-12
- Apr. 19 (1995)
-
- 21. Komaroff, A. L., Bell D.S., Cheney, P.R., Lo, S.C.,
Absence of Antibody
- to Mycoplasma fermentans in patients with Chronic Fatigue
Syndrome,
- Clinical Infectious Disease, 17(6):1074-75 Dec. (1993)
-
- 22. Nicolson, G.L., and Nicolson, N.L., The Eight Myths
of Operation Desert
- Storm and Gulf War Syndrome, Medicine, Conflict &
Survival (1997)
-
- 23. Hannan, P.C., Antibiotic Susceptibility of Mycoplasma
fermentans
- Strains From Various Sources and the Development of Resistance
to
- Aminoglycosides in Vitro, Journal of Medical Microbiology,
Jun.
- 42(6):421-28 Jun (1995)
-
- 24. Poulin, S.A., Perkins, R.E., Kundsin, R.B., AIDS-Associated
Mycoplasmas
- and Antibiotic Susceptibilities, Abstract of American
Society of
- Microbiology Meeting, (1993) (abstract no. G-21)
-
- 25. Poulin, S.A., Perkins, R.E., Kundsin, R.B., Antibiotic
Susceptibilities
- of AIDS-Associated Mycoplasmas, Journal of Clinical Microbiology,
Apr.
- 32(4):1101-03 Apr (1994)
-
- 26. Vojdani, Ari, Immunology of Chronic Fatigue Syndrome,
pp.36-42 (1997)
-
- Courtesy of Sharon Briggs SHASTA CFIDS
-
- Antibiotics Recommended When Indicated for Treatment
of Gulf War
- Illness/CFIDS/FMS
-
- By Prof. Garth L. Nicolson
- The Institute for Molecular Medicine
- 15162 Triton Lane, Huntington Beach, California 92649-1041
- Tel: (714) 903-2900 Fax: (714) 379-2082
- e-mail: gnicimm@ix.netcom.com
-
- Doxycycline (AKA Vibramycin, Monodox, Doxychel, Doxy-D,
Doryx)
-
- Doxycycline is a broad spectrum tetracycline with good
lipid solubility and ability to penetrate the blood-brain-barrier. This
antibiotic acts by inhibiting microorganism protein synthesis, it is readily
absorbed by the (normal) gut, and peak blood concentrations are maintained
between 2-18 hours (half-life 18-22 hours) after an oral dose of drug.
Food, calcium, magnesium and antacids reduce absorption, and alcohol, phenytoin
[Dilantin] or barbiturates reduce blood half-life.
-
- For Gulf War Illness/Chronic Fatigue Syndrome/Fibromyaligia
Syndrome (GWI/CFIDS/FMS) use, the recommended dose is 200-300 mg/day (oral,
2-3x100 mg capsules) for each 6 week cycle of therapy. Initially, doxycycline
initially exacerbates symptoms (Herxheimer reactions or adverse antibiotic
responses, such as transient fever, skin, gut discomfort, etc.) but these
are usually gone within 2 weeks or so. Patients usually start feeling better
with alleviation of most major signs and symptoms within 2-6 weeks, but
in some patients major symptoms are not alleviated until the second 6-week
course. Severe reactions or prior damage to the gastrointestinal system
may require I.V. administration of 100-150 mg/day (rapid I.V. administration
is to be avoided) for 2-3 weeks, then the remainder of the 6 week course
should be on oral antibiotic (to avoid thrombophlebitis complications which
can occur with prolonged I.V. therapy). Some react to the starch filler
in the capsules and must use Doryx, a granular form of doxycycline.
-
- Virtually all patients relapse (show the same major signs
and symptoms) after the end of the first and second 6-week course of therapy,
and these can be run together without a pause. In a pilot study, 85% relapsed
after 2 cycles, and after 5 and 6 cycles, 27% and 11%, respectively, still
relapsed after discontinuing antibiotic therapy.
-
- In some cases doxycycline has been used successfully
with other antibiotics in situations where either antibiotic alone appeared
to have minimal effect (for example, doxycycline in combination with Ciprofloxacin).
Doxycycline is primarily bacteriostatic and effective against the following
organisms: gram-negative bacteria (N. gonorrhoeae, Haemophilus influenzae,
Shigella species, Yersinia pestis, Brucella species, Vibrio cholera); gram-positive
bacteria (Streptococcus pneumoniae, Streptococcus pyogenes); mycoplasmas
(Mycoplasma pneumoniae, Mycoplasma fermentans [incognitis], Mycoplasma
penetrans); others (Bacillus anthracis [anthrax], Clostridium species,
Chlamydia species, Actinomyces species, Entamoeba species, Treponema pallidum
[syphilis], Plasmodium falciparum [malaria] and Borelia species).
-
- Precautions: Avoid direct sunlight and drink fluids liberally.
Doxycycline therapy may result in overgrowth of fungi or yeast and nonsensitive
microorganisms (see Other Considerations). Patients on anticoagulants may
require lower anticoagulant doses. Last half of pregnancy, infancy and
children under 8 years are not recommended, in the latter case due to tooth
discoloration, but lower doses of doxycycline have proven to be very effective
in children under 8 with GWI/CFIDS (if weight 100 lbs. or less, 1-2 mg/lb.
divided into two doses; if is weight over 100 lbs. use adult doses). Patients
with impaired kidney function should not take doxycycline, and the following
drugs should not be taken with doxycycline: methoxyflurane [Penthrane],
carbamazepine [Tegretol], digoxin or diuretics.
-
- In case of complicating bacterial infections, a 2 week
course of Augmentin (3 X 500 mg/day) should be taken between courses of
doxycycline or other antibiotics. For fungal and yeast complications, please
see the instructions under. Other Considerations at the end of this handout.
-
- Adverse Reactions: In a few patients doxycycline causes
gastrointestinal irritation, anorexia, vomiting, nausea, diarrhea, rashes,
mouth dryness, hoarseness and in rare cases hypersensitivity reactions,
hemolytic anemia, skin hypersensitivity and reduced white blood cell counts.
In general, doxycycline is considered a safe drug, in that there are few
adverse reactions reported in the literature.
-
- Ciprofloxacin (AKA Cipro, Cifox, Cifran, Ciloxan, Ciplox)
-
- Ciprofloxacin is a broad spectrum synthetic fluoroquinolone
antibiotic with good absorption characteristics. This drug acts on bacterial
DNA gyrase to inhibit bacterial DNA synthesis. Ciprofloxacin is secreted
rapidly in the urine and has a half-life in the blood of about 4 hours.
Food delays the absorption of antibiotic (by ~2 hours) but not the total
absorption; antacids containing magnesium, aluminum or other salts reduce
absorption and should not be taken at the same time of day.
-
- For GWI/CFIDS/FMS use, the recommended dose is 1500 mg/day
(for oral use, 3x500 mg capsules) for each 6 week cycle of therapy. Ciprofloxacin
may or may not be taken with meals. Initially, Ciprofloxacin may exacerbate
some symptoms (Herxheimer reactions or adverse antibiotic responses) but
these are usually gone within a week or so, and some patients report that
doses of 1000 mg/day or lower are not effective in alleviating GWI/CFIDS/FMS
symptoms. Patients usually start feeling better with alleviation of most
major signs and symptoms within 1-4 weeks, but in some patients major symptoms
are not alleviated until the second 6-week course. Ciprofloxacin has been
used in patients in which doxycycline cannot be tolerated or in some patients
that no longer respond to doxycycline. In a few cases Ciprofloxacin has
been used simultaneously with doxycycline, but the usual course is one
type of antibiotic alone.
-
- Herxheimer reaction, if present, usually passes within
a few days to 2 weeks or so; prior damage to the gastrointestinal system
may require I.V. administration of 400 mg/day (over one hour per each infusion,
rapid I.V. administration is to be avoided) for 2-4 weeks, then the remainder
of the 6-week course should be on oral antibiotic (oral doses). Virtually
all patients relapse (show the same major signs and symptoms) after the
end of the first or second 6-week course of therapy. Additional cycles
of antibiotic result in milder relapses after drug is discontinued. Subsequent
cycles of antibiotics may require the use of doxycycline or other antibiotics
instead of Ciprofloxacin.
-
- Ciprofloxacin is effective against the following organisms:
gram-negative bacteria (Shigella species, Citrobacter diversus, Citrobacter
freundii, Escherichia coli, Klebsiella pneumoniae, Haemophilus influenzae,
Enterobacter species, Proteus vulgaris, Psuedomonas aeruginosa, Yersinia
pestis, Vibrio cholera); gram-positive bacteria (Streptococcus pneumoniae,
Streptococcus pyogenes, Staphylococcus hominis, Staphylococcus saprophytieus);
mycoplasmas, moderately active (Mycoplasma species); others (Clostridium
species, Chlamydia species, Mycobacterium tuberculosis).
-
- Precautions: Direct sunlight is to be avoided, and patients
should not take Ciprofloxacin and theophyline concurrently. Ciprofloxacin
therapy may result in drug crystals in the urine in rare cases, and patients
should be well hydrated to prevent concentration of urine. Pregnant women
and children should not use this drug due to reduction in bone and cartilage
development.
-
|