RE: IOWA group Barb /Kate

[Guest guest]

Pity the improvements are not quantified , still the conclusions are informative

Macrolide therapy of chronic Lyme Disease.Donta ST.Boston University Medical Center, 650 Albany Street-8th Floor, Boston, MA 02118, U.S.A. sam.donta@...BACKGROUND: Macrolide antibiotics are highly active in vitro against B.burgdorferi, but have limited efficacy in the treatment of patients with Lyme Disease. As macrolides are less active at a low pH, their poor clinical activity might be due to localization of borrelia to an acidic endosome, and their activity improved by alkalinization of that compartment with hydroxychloroquine. MATERIAL/METHODS: 235 patients with a multi-symptom complex typical of chronic Lyme disease, ie fatigue, musculoskeletal pain, and neurocognitive dysfunction and with serologic reactivity against B.burgdorferi were treated with a macrolide antibiotic (eg clarithromycin) and hydroxychloroquine. RESULTS: Eighty % of patients had self-reported improvement of 50% or more at the end of 3 months. After 2 months of treatment, 20% of patients felt markedly improved (75-100% of normal); after 3 months of treatment, 45% were markedly improved. Improvement frequently did not begin until after several weeks of therapy. There were no differences among the three macrolide antibiotics used. Patients who had been on hydroxychloroquine or macrolide antibiotic alone had experienced little or no improvement. Compared to patients ill for less than 3 years, the onset of improvement was slower, and the failure rate higher in patients who were ill for longer time periods. CONCLUSIONS: These results support the hypothesis that the Lyme borrelia reside in an acidic endosome and that the use of a lysosomotropic agent augments the clinical activity of macrolide antibiotics in the treatment of patients with chronic Lyme Disease. In contrast, the efficacy of tetracycline in such patients is not affected by hydroxychloroquine.PMID: 14586290 [PubMed - indexed for MEDLINE]

-----Original Message-----From: Kate [mailto:KateDunlay@...]Sent: 14 March 2005 14:13infections Subject: Re: [infections] IOWA group (HCQ/Fluconazole/Mino/Schardt)On Monday, March 14, 2005, at 09:24 AM, Barb Peck wrote:

I've been reviewing the papers which indicate that of raising the PHin the cell may allow for synergistic killing at lower doses of someabx in combo.From my own experience, I know this is true for HCQ(Hydroxychloroquine) and Mino. That's basically the protocol Sam Donta uses. He wrote "Macrolide Therapy of Chronic Lyme Disease." He said HCQ helps macrolide antibiotics but he does not believe (in that paper anyway) that it helps mino. My son is on Zithromax and HCQ now.- Kate D.