Macrolides

Hi All, I was looking at some various Cpn MICs for macrolides. An interesting and perhaps unsurprising note is that the ones that appear to be preferred have longer half lives. I have always thought Clarithromycin was one of the better Cpn drugs (although perhaps with more side effects). What have other people's experiences with these been? Has anyone tried more than one and have a preference in terms of side effects and/or efficacy? Clarithromycin (MIC 0.012 mg/L) 3-4 hour half life Roxithromycin (MIC 0.03 mg/L) 12 hour half life Erythromycin (MIC 0.05 mg/L) 1.5 hour half life Azithromycin (MIC 0.125 mg/L) 68 hour half life - Paul

Hi Paul, maybe you are a bit more savvy about medication than I am, but so far we have only stuck to the standard protocol, I take Azi and my daughter takes Roxi, although Ella only changed to Roxi after she found it difficult to tolerate the depression that seemed to be aggravated by Azi. I know that half life was a consideration in the original thinking.

I don't know enough about the chemistry and the biology to have experimented with different drugs to make informed judgements. I trust the people who have done the research before devising and adjusting the protocol and their reasons for chosing the drugs they did.

Michele (UK) GFA: Wheldon CAP 1st May 2006. Daily Doxy, Azi MWF, metro pulse. Zoo keeper for Ella, RRMS, At worse EDSS 9, 3 months later 7 now 5.5 Wheldon CAP 16th March 2006

Michèle (UK) GFA: Wheldon CAP 1st May 2006. Daily Doxy, Azi MWF, metro pulse.

Hi Paul

I definitely agree about the Biaxin/Clarithromycin.  I just swithched yesterday and had a strong ipath..response.

Can you tell me where you are at in your healing.  Are you in treatment and if so what combo?  I remember many of your posts awhile back and wondered if you would ever post again as I enjoyed your insight.

 

Hi Presacarario, could you define ipath for the clarification of my understanding as I follow this topic?   Thanks, Louise

Louise, USA, Northern New England. CPn, Bb(Borrelia B., Lyme,) CFS.     Started CAP 6/24/07 Doxy400, NAC1200.  Currently 9/24/07, Doxy 200 mg, NAC 2400 mg. 

  • CAP(TiniOnly): 06/07-02/09 for CFS
  • MethylationProtocolSupplements: Started08/08
  • Intermtnt CAP: 02/09-02/10
  • Full MethylProtocol & LDN 02/09
  • Off CAP: 02/10, cont LDN & MethlyProtocol support

Can you tell me where you are at in your healing. Are you in treatment and if so what combo? I remember many of your posts awhile back and wondered if you would ever post again as I enjoyed your insight. Thanks for asking. I am doing great these days. I went from what would be considered full blown CFIDS a year or two ago to being about as well as I have been in my adult life. Lots of the usual improvement such as strength, energy, and cognitive function. And quite a few smaller things such as clearing up tinnitus, sinus problems, and skin disorders. I probably should not discuss what I have tried without giving it some thought. Some of the things I tried were probably good ideas and some were probably ill considered, maybe even dangerous ;) - Paul

Hi Paul,

My understanding from the limited information that I have is that Roxithromycin is the one in this group that crosses the BBB is that correct? That is and advantage in many ways.  

Very long half life is something that the pharmceutical industry is working towards as it advances towards new drugs in general. 

Many reasons, my guesses are from a patient compliance and justification for higher pricing.  Folks tend to get off schedule and miss many dose of medication in general the more often they need to be taken.

Also administration costs in health care facilities are increased each time someone has to give medications to a patient (pass medications out in mass to the patients).  Even licensed staff can be reduced by reducing the medication distribution load, which is quite high in the number of medications for numerous symptoms as the state of declining health progresses, therefore decreasing the number of times a day that a medication needs to be dosed is desired outcome that can cut costs and/or increasing profits.

And the physical challenges for some folks due to individual differences in physiological processing of drugs in the body could cause some folks to exceed safe blood levels at generally acceptible amounts and resultingly have a toxic effects of drugs that cannot be excreted in a reasonable amount of time (adverse drug reactions). I am sure there is a more concise way of saying this but this is explanatory.  Perhaps it is drug induced morbidity. 

I quite enjoy your postings and discussions.  Currently I do not have the drive or access to online data that would give such specific information and for myself I find the discussion relevent.

Thanks for posting and sharing.    Louise

 

 

Louise, USA, Northern New England. CPn, Bb(Borrelia B., Lyme,) CFS.     Started CAP 6/24/07 Doxy400, NAC1200.  Currently 9/24/07, Doxy 200 mg, NAC 2400 mg. 

  • CAP(TiniOnly): 06/07-02/09 for CFS
  • MethylationProtocolSupplements: Started08/08
  • Intermtnt CAP: 02/09-02/10
  • Full MethylProtocol & LDN 02/09
  • Off CAP: 02/10, cont LDN & MethlyProtocol support
D W

My belief is that azithromycin, roxithromycin and telithromycin have been shown to enter the brain. The first two are useful in the treatment of intrecerebral C. pneumoniae infection. I'm wary of telithromycin because of the risk to the liver. D W - [Myalgia and hypertension (typically 155/95.) Began (2003) taking doxycycline and macrolide and later adding metronidazole. No medication now; just supplements and IR sauna. Morning BP typically 110/75]
D W - [Myalgia and hypertension (typically 155/95.) Began (2003) taking doxycycline and macrolide and later adding metronidazole. No medication now. Morning BP typically 110/75]

Hi David, I think one could make a reasonable argument for any number of these. Roxithromycin probably does the best job at crossing the BBB. Azithromycin has the longest half life and therefore requires less frequent dosing and it also builds up to higher levels inside of cells. And clarithromycin is the most bacteriocidal of these macrolides against Cpn. I did not add telithromycin as it was not on the list I was looking at and MIC and MBC numbers do not seem to be standardized well enough to correlate from different labs. In any event, I agree with your rationale for MS. It is possible that they would not be the ideal choices for other diseases though. - Paul

I must say that a combo of mino, biaxin and plaquenil has really packed a punch for Jim lately. Although he has always seemed to have a pretty sporty die-off from zith, the clarithromycin has stirred things up considerably at 1000 mgs per day. Jim is onto Roxi next----I am pretty excited even as Jim is a bit aprehensive. Lexy --------------- "Chance favors the prepared mind." --Louis Pasteur Husband treating MS with CAP
--------------- "Chance favors the prepared mind." --Louis Pasteur Husband treating MS with CAP

Another past topic, I commented on this one just before I began my course of Roxi.    Interesting discussion.    Louise
  • CAP(TiniOnly): 06/07-02/09 for CFS
  • MethylationProtocolSupplements: Started08/08
  • Intermtnt CAP: 02/09-02/10
  • Full MethylProtocol & LDN 02/09
  • Off CAP: 02/10, cont LDN & MethlyProtocol support