Strep=>L-Form=>tetra abx?

[aynurrzepa]

Can smebody pls help me quickly with this doubt I have – I read all the recommended books and here is what I figured. Is my line of thinking correct?

Strep infections can hide by turning into L-forms which can continue triggering a rheumatic decease and L-forms can be treated by tetra abx, just like mycoplasmas? If so, what is the best abx for strep L-forms – will mino or doxy have the required effect or other abx must be used? What are the other abx – other tetras like azythromicin or from the penicillin group?

I’ll try asking this Q from Dr S as well but he not always answers or at least did not asnwer my last e-mail…

Thanks!

[Todd WI]

“7. … Sometimes mycoplasma and strep coexist together. If an ASO for strep titer is performed, many rheumatic disease patients test positive. The strep needs to be treated with an appropriate antibiotic for the rheumatic disease to respond.”

https://www.roadback.org/index.cfm/fuseaction/education.display/display_id/89.html

I seem to recall Dr. Brown talking about using amoxicillin, but sometimes my recollection isn’t very good.

Todd

[Maz]

@aynurrzepa wrote:

Strep infections can hide by turning into L-forms which can continue triggering a rheumatic decease and L-forms can be treated by tetra abx, just like mycoplasmas? If so, what is the best abx for strep L-forms – will mino or doxy have the required effect or other abx must be used? What are the other abx – other tetras like azythromicin or from the penicillin group?

Hi Aynur,

I think Dr. S. might be a bit of a snow-bird, now he’s semi-retired, so may be taking time during the winter months to enjoy some sunshine? I recall last year that he went off for a bit of an extended vacation during the winter. It’s also near Christmas, so he might be enjoying the holidays?

This is an excellent link describing all the various strep species you might find interesting:

http://www.textbookofbacteriology.net/streptococcus.html

Azithromycin is in the macrolide class of antibiotics and sub-class of this class, called Azalides. It’s a broad spectrum antibiotic, meaning that it has both bacteriostatic and bacteriocidal properties and so it can hit both cell-walled and cell-wall-less bugs (like L-forms and mycoplasma).

http://en.wikipedia.org/wiki/Azithromycin

The easiest way to describe various classes of abx is by their actions. Some are bacteriostatic, some bacteriocidal and some are broad spectrum, meaning they have both properties.

Tetracyclines are actually only bacteriostatic (other examples include Bactrim and Sulphonamides). Bacteriostatic antibiotics work by penetrating cell walls and the thin outer-lipid layer of cell-wall-less organisms to disable them by interfering with certain enzymatic processes they need for surivial, growth, reproduction… So, these antibiotics are valuable for hitting mycoplasma and organisms that have an L-form, called CWDs or cell-wall deficients. So, tetras do not kill bugs, they just disable them…the immune system then goes in for the kill and to clear away the debris.

Penicillins are in a class called bacteriocidal. This is because their action is to compromise an organism’s cell wall and, thus, kill it outright. Examples would be amoxicillin, augmentin, ampicillin, Moxatag, etc. These bacteriocidal abx only work when an organism is in a cell-walled form. Other examples of bacteriocidal agents are ones, such as, cephalosporins or nitroimidazoles (e.g. flagyl or tinidazole).

The broad spectrum abx, like macrolide antibiotics, have properties that are both bacteriocidal and bacteriostatic…hence, why they are called, “broad spectrum,” as they target both CWDs and cell-walled forms. Examples would be clindamycin, azithromycin, clarithromycin, erythromycin, roxithromycin, etc. When the source of an infection isn’t very clear, a broad spectrum abx might be used to cover a multitude of “sins,” so to speak.

So, an effective antibiotic and one that would compliment minocycline is one such as azithromycin, which has both bacteriostatic and bacteriocidal properties. This type of antibiotic boosts AP, as it is hitting both CWDs and cell-walled organisms. I think Brown did use ampicillin to help lower patient’s strep titers and there is nothing wrong with this, except that azithromycin won’t interact with a tetracycline, whereas penicillins can reduce their effectiveness.

Does this help, Aynur? Usually, what I do when I don’t understand a particular abx’s actions, I look it up on drugs.com or wiki. Both are great resources for this.

[paper tiger]

Is there by any chance a resource I can print out and take to my AP doc about adding in other antibiotics? The Roadback website doesn’t have much besides “A proper chemotherapeutic approach must recognize that tetracyclines and erythromycins are effective against many mycoplasma infections; some are resistant to one strain or the other. Mycoplasma testing to isolate the strain may be necessary (See Appendix A).”

He also doesn’t want to test for mycoplasma because he says there’s so many strains, we’d have to do so many tests and send them all over the place in the States (expensive), and that it doesn’t particularly matter?

I’m not so sure I’m responding to Minocin alone, but my doc also doubles as a naturopath and needs a little needling for drugs. He’s great because he wants to use alternatives to methotrexate et al., but bad because he often tries to suggest that mushroom food and hippie stuff are the alternative. I really want to ask him for Zithromax when I next see him, but I don’t want to go in without something to substantiate it (beyond “well, these people on this message board…”, which I am assuming is every doctor’s nightmare).

[Maz]

@paper tiger wrote:

Is there by any chance a resource I can print out and take to my AP doc about adding in other antibiotics?

He also doesn’t want to test for mycoplasma because he says there’s so many strains, we’d have to do so many tests and send them all over the place in the States (expensive), and that it doesn’t particularly matter?

I’m not so sure I’m responding to Minocin alone, but my doc also doubles as a naturopath and needs a little needling for drugs.

I really want to ask him for Zithromax when I next see him, but I don’t want to go in without something to substantiate it (beyond “well, these people on this message board…”, which I am assuming is every doctor’s nightmare).

Hi Tracy,

Unfortunately, in this type of situation, this is where an experienced physician comes into play (especially one who adheres to infectious theory). At present, there are no studies on alternative abx for SD, other than minocycline (the Mino in Early Diffuse Sclero Trials) and it is all anecdotal evidence.

Your doc is right, performing mycoplasma testing is probably not worth doing, not unless you intended to keep testing at intervals to watch the titers come down, as Brown would have done, and this is pretty expensive. This is because everyone has probably been exposed to one strain or other of mycoplasma during their lifetime (rheumatics just tend to respond to them differently, as per Brown’s “bacterial allergy” theory). I spoke with Millie Coker-Vann at TARCI labs (she worked with Brown) recently and asked her this question and she also conceded that a one-off test probably wouldn’t say much. The reason AP docs, like Dr. S., run myco testing during an initial consult is really to code the IVs for infections for health insurance purposes. Insurance will cover IVs for myco infections, but not for rheumatic diseases, essentially.

The only thing I can suggest to you is to give your doc the two Scammell books and ask him to read them, because Brown does talk about other classes of abx he used in the books.

You will also find some info at the following link from Dr. F, in CA, about the other abx he employs:

http://www.rheumatic.org/faq.htm

My best suggestion to you would be to also give your doc, Dr. S.’s contact info and ask him to consult with Dr. S. on your behalf. It is still very early days – just 3 to 4 months – of being back on AP, so you might not experience any significant improvements for a while yet. SD can be a bit of a freight train when it starts, so it can take a while to slow progression and then for symptoms to finally being to reverse. Some SDers may not see improvements for the first year or so.

Would you like me to send you Dr. S.’s contact details, Tracy, or do you have them?

[paper tiger]

Hey Maz,

yes, please send those details over! Do you find Dr S is generally happy to consult with other doctors? I will definitely try to arrange something if yes. I know my AP doc has enormous respect for Dr A in Ottawa and I am trying to get an appointment with her to sort of touch base and maybe get her in touch with Dr D.

I know you volunteers keep details on your list of AP docs, so may I just add that Dr D unfortunately thinks that Lyme is an insane myth and that I should never think about it again.

Thank you!
Tracy

[Maz]

@paper tiger wrote:

yes, please send those details over! Do you find Dr S is generally happy to consult with other doctors? I will definitely try to arrange something if yes. I know my AP doc has enormous respect for Dr A in Ottawa and I am trying to get an appointment with her to sort of touch base and maybe get her in touch with Dr D.

I know you volunteers keep details on your list of AP docs, so may I just add that Dr D unfortunately thinks that Lyme is an insane myth and that I should never think about it again.

Hi Tracy,

Yes, would be happy to send you Dr. S’s contact info in a PM. He’s very kind about consulting with other physicians wanting to learn the therapy or to consult on particular patient cases. He may be busy with the holidays, as he’s semi-retired now, but if you put in a call and leave a message or write an email, am sure he will eventually reply.

That’s too bad about Dr. D. thinking that Lyme is a myth…unfortunately, most do, unless they experience it themselves.

Lyme in Quebec:

http://www.inspire.com/groups/scleroderma-foundation/discussion/lyme-and-other-diseases/

There is a ton of evidence out there that Lyme persists beyond the prescribed IDSA treatment guidelines, but unfortunately, much of it doesn’t make the big peer-reviewed journals, because the peers reviewing it are IDs! 😡 Here’s just a sampling, but there is a plethora of evidence out there:

Persistence of Lyme Organism Following Antibiotic Treatment in Mice

On March 3rd, 2008, the Center for Comparative Medicine, Schools of Medicine and Veterinary Medicine, University of California at Davis published a significant study demonstrating the persistence of Borrelia burgdorferi in collagen-rich tissues of infected mice with both early and late stage infection following treatment with the antibiotic ceftriaxone for one month.

Source: http://aac.asm.org/cgi/content/abstract/AAC.01050-07v1

More Evidence to Support the Persistence of Lyme Disease

On September 25th, 2008, a new study was published, demonstrating the persistent, pleomorphic nature of Borrelia burgdorferi found in cases of patients with neurological Lyme disease.

Source: http://www.jneuroinflammation.com/content/5/1/40

Systemic Scleroderma linked to Lyme Disease

In January, 2005, an article was published in the Journal of the European Academy of Dermatology & Venerology describing the case of a 61-year-old woman who exhibited signs mimicking those of diffuse systemic scleroderma and testing positive for Lyme disease. Previously, although cases of skin sclerosis had been linked to an infection with Borrelia burgdorferi, the authors state that no such association had yet been reported for systemic scleroderma until this time.

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