Zithromax vs Biaxin or Ketek
Zithromax seems to be what everyone is using here for CPNi. Has anyone tried Biaxin or Ketek insted? These are macrolides also, and in theory should work against CPN when used in combo with a Tetra + Flagyli.
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Dr. Stratton has said that in their clinical experience the other macrolides tended to create resistance in long term use. Additionally, ketek has a history of creating tendon problems in long term use. Since this is a long term protocol, it's important to use meds which are safe for long term use and are less likely to result in resistance.
CAPi for Chlamydia pneumonia since 11/04. 25yrs CFSi & FMSi- Currently: 150mg INHi, 300mg Rifampin, 200 Doxycycline, 500mg mwf Azithromycin, plus 500mg Tinidazole 2x/day pulses every two weeks. Whew! That's a lot! abou
CAPi for Cpni 11/04. Dxi: 25+yrs CFSi & FMSi. Currently: 250 aithromycin mwf, doxycycline 100mg BIDi, restarted Tinii pulses; Vit D2000 units, T4 & T3, 6mg Iodoral
Yes, Jim's right there: azithromycin or roxithromycin, which I use, are the best for long term use. Besides, ketek can be possitively dangerous: look it up........Sarah
An Itinerary in Light and Shadow.Wheldon regime since August 2003, for very aggressive SPMSi. Intermittent therapy after one year. 2006 still take this, now two weeks every three months. EDSS was about 7, now 2. United Kingdom.Mark Walker - Oxford, England.
RRMSi Nov 91, Dxi 97. CFSi Jan03. Copaxone + continuous CAPi (NACi, Dox, Rox) Feb06 to May 07. Met pulses from Jun06. Intermittent Abxi from June 07 onwards.
Thanks Mark- good to know you are around!
CAPi for Chlamydia pneumonia since 11/04. 25yrs CFSi & FMSi- Currently: 150mg INHi, 300mg Rifampin, 200 Doxycycline, 500mg mwf Azithromycin, plus 500mg Tinidazole 2x/day pulses every two weeks. Whew! That's a lot! abou
CAPi for Cpni 11/04. Dxi: 25+yrs CFSi & FMSi. Currently: 250 aithromycin mwf, doxycycline 100mg BIDi, restarted Tinii pulses; Vit D2000 units, T4 & T3, 6mg Iodoral
June 29, 2006
An Itinerary in Light and Shadow.Wheldon regime since August 2003, for very aggressive SPMSi. Intermittent therapy after one year. 2006 still take this, now two weeks every three months. EDSS was about 7, now 2. United Kingdom.A new report explains that Ketek labels will need to include additional warnings, and that patients should be on the lookout for liver problems. Read on for further information.
Courtesy of the FDA
The Food and Drug Administration notified healthcare professionals and patients that it completed its safety assessment of Ketek (telithromycin), indicated for the treatment of acute exacerbation of chronic bronchitis, acute bacterial sinusitis and community acquired pneumonia of mild to moderate severity, including pneumonia caused by resistant strep infectionsi. The drug has been associated with rare cases of serious liver injury and liver failure with four reported deaths and one liver transplant after the administration of the drug. FDA determined that additional warnings are required and the manufacturer is revising the drug labeling to address this safety concern. FDA is advising both patients taking Ketek and their doctors to be on the alert for signs and symptoms of liver problems. Patients experiencing such signs or symptoms should discontinue Ketek and seek medical evaluation, which may include tests for liver function.
“We are advising both patients taking Ketek and their doctors to be on the alert for signs and symptoms of liver problems," said Dr. Steven Galson, Director for FDA’s Center for Drug Evaluation and Research. "Patients experiencing such signs or symptoms should discontinue Ketek and seek medical evaluation, which may include tests for liver function." The signs and symptoms of liver failure include fatigue, malaise, loss of appetite, nausea, yellow skin and dark-colored urine.
FDA will continue to evaluate Ketek-associated safety issues and take further actions if warranted. It is important to note that negative effects on liver function are a known and potential complication with some antibioticsi, including Ketek, and as drug usage becomes more widespread, it is expected that rare adverse events may be detected or reported in greater numbers."
........Sarah
Any agent which has the ability to kill intracellulari Chl pneumoniae can give rise to liver problems if that organ is heavily parasitized. In some people the liver may quietly accrue a very large chlamydial load; it's an organ of filtration, and it filters the portal venous circulation which carries the blood from the gastrointestinal tract (stomach to rectum) very thoroughly. Any toxins in the portal circulation will impact on the liver, and toxins exacerbate Chl pneumoniae infection. Some persons with chronic Chl pneumoniae infection will get mesenteric vasculitisi. This would be likely to allow more toxins, including endotoxinsi, into the portal system. Many of these Chl pneumoniae pathologies seem to be additive. The sudden killing of hepatocyte-dwelling chlamydia would release a barrage of free-radicals and other toxins, which may well be enough to damage and kill adjacent non-infected cells.
What's the solution? First of all, protect the liver with N-acetyl cysteine. This is a very powerful antioxidanti, and restores intracellulari glutathione. It gives excellent liver protection, and is in fact used in the treatment of paracetamol (acetaminophen) overdose, which is characterised by hepatic failure. Selenium is required also: reduced glutathione (GSH) neutralizes peroxides in the presence of a peroxidase which needs Se to function. Other antioxidantsi are helpful. Alpha-lipoic acid is liver-protective, and is used in the treatment of Amanita phalloides (Death Capi) poisoning (link). Vitamins C and E are helpful. These supplements are very useful from the word go, even before starting antibioticsi. And then antibiotics are best started gradually, using the least hepatotoxic first. Doxycycline has been associated with liver disease, but it is very, very rare. And then macrolides, such as azithromycin or roxithromycin, can be added cautiously. There's no reason why this schedule shouldn't be continued for months before metronidazole pulses are added. One of the reasons behind pulsing the metronidazole is to allow toxins and bacterial antigens to be cleared away. Rifampicin is a potent killer of Chl pneumoniae and should be reserved until such time as the bacterial numbers are low.
And Ketek (telithromycin)? Clinical experience with it is very limited. It's a new drug, and my own feeling is that other, better-known alternatives exist. We are doing something new here, and when doing something new one doesn't want too much novelty. The prolonged half-life of azithromycin, its efficacy against Chl pneumoniae in vitro and its ability to penetrate the brain would commend this antibiotic.
D W - [Myalgia and hypertensioni (typically 155/95.) Began (2003) taking doxycycline and macrolide and later adding metronidazole. Normotensive.