What do fluconazole tablets do?
FLUCONAZOLE (Diflucan(R)) is an antifungal type of antibiotic. It treats serious fungal infections found throughout the body. These include oral candidiasis or thrush infections of the mouth or throat, vaginal yeast infections, candidal infection of the urinary tract, meningitis, and others. Generic fluconazole tablets are not yet available.
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URL=http://www.immunesupport.com/library/showarticle.cfm/id/6431]http://www.immunesupport.com/library/showarticle.cfm/id/6431[/URL]

A New Approach to Chronic Lyme Disease
ImmuneSupport.com

05-11-2005

By Jill Neimark

In May of this year I sat down at the beautiful Essex House on
Central Park South, with a German physician specializing in internal
medicine, Fritz Schardt. Dr. Schardt, who is associated with the
University of Wurzburg in Germany, published an interesting pilot
study in the European Journal of Medical Research in July of 2004 on
the use of an antifungal drug, fluconazole, in treating chronic,
advanced lyme disease. This pilot study examined 11 patients with
chronic lyme. Dr. Schardt has slowly refined the protocol since then,
and believes it holds great promise in treating this difficult
condition--which is often misdiagnosed as chronic fatigue or
fibromyalgia. Here follows our interview:

Jill Neimark (JN): What made you think of using diflucan, an
antifungal, to treat lyme disease?

Dr. Fritz Schardt (FS): I was actually my first patient. I got lyme
disease in 1989, and was given two weeks of doxycycline. Our country
follows the protocols set by yours, so that's what is generally
recommended. I now know that was very inadequate and I do not think
doxycycline should be used in early lyme disease at all. It is only
bacteriostatic, meaning it inhibits the bacteria but does not kill
them.

JN: I know, the same thing happened to me. At the doses they
recommend, it also does not penetrate the central nervous system. I
had a fever, stiff neck and bullseye rash. The stiff neck means it
was already in my nervous system. Therefore I probably needed six to
eight weeks of doxycycline at double the dose I was given. Higher
doses will penetrate the CNS.

FS: Right. I recommend penicillin in early lyme disease.

JN: Amoxicillin is given here. Is that what you recommend?

FS: No, that's broad spectrum, so you end up killing many bacteria,
including necessary ones in your gut. I recommend smaller spectrum
penicillins. The syphilis spirochete has not become resistant to
penicillin, and there's good evidence that borrelia, the lyme
spirochete, has not either. In Germany, we have cefalosporine,
roxithromycin, cotrim-TMPO, and clarithromycin. These are all good
choices. They should still be taken for 20-30 days.

JN: Okay, well, you took doxycycline so you ended up with chronic
lyme disease. What happened then?

FS: I was sick for 18 months. I was given intravenous rocephin
several times. I would feel better, but then once I stopped taking
the antibiotics, I relapsed. I was often bedridden and I thought I
was ready for the wheelchair. Then, I developed a fungal infection,
possibly because of all the antibiotics. So I was put on diflucan.
This was around 1990. It was a new drug that was being used mainly
for opportunistic fungal infections in AIDS patients.

JN: And what happened?

FS: I got better. But I only stayed on it for two weeks at first, and
then I got worse again. So I went back on it for 30 days, and I got
well.

JN: What was the dose?

FS: I took 100 milligrams twice a day.

JN: Are you completely well?

FS: I am very active and energetic and I feel quite well. I have
since competed in athletic events and won them. However, I do have an
occasional heart arrhythmia that I believe may be due to permanent
damage from the spirochete.

JN: Tell me your reasoning as to why diflucan might work in chronic
lyme.

FS: There are several reasons. First of all, it inhibits an enzyme
called cytochrome P450. This is an enzyme that your liver, for
instance, uses to detoxify chemicals and drugs. Borrelia has a very
primitive p450 defense, so if you inhibit it, it is easily weakened.
Therefore I believe that diflucan inhibits the growth and replication
of borrelia. It does not necessarily kill it. In addition, it
penetrates well into the cells and into the nervous system and brain,
where borrelia may hide.

JN: What is your current protocol?

FS: I recommend 200 milligrams a day, for 50 days. There are now 200
milligram pills available, so once a day is fine. Then I recommend 20-
30 days of any of the penicillins I mentioned. You may have to go
through several cycles of this protocol. You must also be very aware
of other drugs that act on the p450 enzyme system, specifically a
subset that inhibits CYP3A4. You should not be taking any of these
drugs at the same time as you take diflucan.

JN: What are some of these drugs?

FS: There are many, and it's best to check with your doctor. Some
common ones are erythromycin, amitryptylin, midazolam, Lovastatin,
and others.

JN: I hate antibiotics. Do you have to take the penicillin?

FS: I understand, many lyme patients come to hate antibiotics because
they have to take so many of them for so many years and are still
ill. In fact, I also was made ill by the antibiotics.

JN: They really disrupt your digestion.

FS: Right, that was my problem.

JN: So, this protocol is your best one-two punch against borrelia,
but you don't have to take the antibiotics if you truly hate them.

FS: Right. In addition, diflucan has a slow half-life so it can
slowly build up in your bloodstream. Sometimes patients call me after
a few weeks and say they are feeling very ill on the protocol.
Perhaps it's a herxheimer, or perhaps it's that the levels of
diflucan are higher than they can tolerate. So I say, take a 3 or 4
day pause, and then go back on the protocol. This is perfectly
acceptable.

JN: What happens if you have a weak p450 system? Have any of your
patients have raised liver enzymes from the diflucan?

FS: I have been lucky, not one of my patients have had raised
enzymes. It is generally well tolerated. If it is a problem, however,
you can lower the dose of diflucan. This would be overseen by your
doctor. I recommend 100 milligrams in pediatric cases.

JN: How many patients have you treated now?

FS: At least eighty.

JN: What is the most difficult case you've had?

FS: I have one 75-year-old patient who has had lyme for 18 years. He
was very ill. He has had to do this cycle of diflucan and penicillin
3 times. He is much, much better. In fact, he's so happy with his
improvement he called the drug manufacturer to tell them they need to
run a publicity campaign to promote diflucan for chronic lyme
disease.

JN: Some patients on some internet groups are adapting your protocol,
probably in concert with their doctors, and I'd like to know what you
think of this. They are suggesting staying on diflucan for 9 months,
and some of them are adding in low-dose minocycline. Are you aware of
this?

FS: No, I am not aware of this.

JN: What do you think of the idea?

FS: I believe in the narrow-spectrum penicillins for borrelia, not
the cyclines.

JN: What about 9 months?

FS: That remains to be seen. Perhaps, like tuberculosis, some
patients will need to be on diflucan at least six months or more.
Borrelia is a very sophisticated organism, and one of the few
bacterium with two cell membranes. There is much we still have to
learn about it.

(c) Jill Neimark, 2005.

[This message has been edited by nan (edited 28 July 2005).]
 

Michelle M
 

and will mail to my llmd for his thoughts.
 

If I were to take this for lyme, I'd go with the brand-name and not the generic, so as to get the best bang-out of borrelia for the buck.
 

Check online or with a pharmacist!

nan
 

We're hoping it works... right now we're all feeling like lyme crap.

We believe this is what caused the flare-up of my daughter's heart issues. Also has caused a flare-up of my son's movement disorder. And my headache and neck/back pain...as well as that wonderful fatigue.

These are some of the things that really flare up on us when we are herxing - so my guess is that the diflucan is causing us to herx.

I'll keep you all updated on our progress if you want...?
 

- JB

 

Please do keep us advised about how it's working for you all! Sounds like it is causing you to herx....a good sign?

I noted that this doctor advised backing off if the herx got too bad.

Here's hoping for the best! Good luck!

nan
 

It occurred to me that the European strains of Borrelia are not the same as ours.

Treepatrol: You are amazing! Always coming up with something good for us to read.
Thanks! nan
*************************************
I recommend 200 milligrams a day, for 50 days. There are now 200
milligram pills available, so once a day is fine. Then I recommend 20-
30 days of any of the penicillins I mentioned. You may have to go
through several cycles of this protocol. You must also be very aware
of other drugs that act on the p450 enzyme system, specifically a
subset that inhibits CYP3A4. You should not be taking any of these
drugs at the same time as you take diflucan.

[This message has been edited by nan (edited 29 July 2005).]
 

The big thing to be afraid of is potential damage to the liver. : "You must also be very aware of other drugs that act on the p450 enzyme system, specifically a
subset that inhibits CYP3A4. You should not be taking any of these drugs at the same time as you take diflucan."

I know there are lists out there on the web that delineate drugs that inhibit these enzymes. Quest
 

When I saw my LLMD for the first time, he was impressed with that information and we decided we should give Diflucan a try for about 3 months.

He was aware of the study out of Germany and wonders if yeast might be the MAJOR problem for some of us, even more so then the Lyme. They could be coinfections and I think it is true that when treating lyme or any of the other tick borne diseases it is important to deal with ALL of the coinfections. Getting rid of one, makes it easier to get rid of the next and down the line.

Yeast and Lyme seem to go hand in hand. Treating yeast may be a good place to start. Maybe the first domino to fall.

Then he says: "In Germany, we have cefalosporine, roxithromycin, cotrim-TMPO, and Clarithromycin"

and then says "Then I recommend 20-30 days of any of the penicillins I mentioned"

Strange thing is none of the antibiotics he mentioned are penicillins. The only thing close to a penicillin is cefalosporine which is a generic name for a class of antibiotics and is the same as saying cephalosporins. One of the better cefalosporines (cephalosporins)is rocephin and also oral Cefixime. The other antibiotics he mentioned are roxithromycin (based on erythromycin), cotrim-TMPO (Bactrim), and Clarithromycin (based on erythromycin).

So we have a Dr. that doesn't seem to know what penicillins are. Hmmm.

I tried 200mg Diflucan for over 50 days and it did little to nothing for the late stage lyme. I previously tried many months of oral Cefixime (third gen. oral cephalosporin) with and without azithromycin and it eradicated all signs for about two months but it like many other antibiotics slowly stopped working.

I wonder if the same has happened to his 79 year old i.e. he feels much better due to the cephalosporin and wants to practice the power of positive thinking i.e. write the drug company and tell them I'm cured. I went through the same type feelings after starting azithromycin (I'm cured) Cefixime (I'm cured) Flagyl+azithromycin (I'm cured) but with everyone, a few months later the symptoms slowly returned.
 

SLE...new here? Note that the good doctor said many will require several rounds of the diflucan and penicillin!

nan
 

I herxed in the joints and neuroloically with this...also had some sweats.

But...that is all gone.

My local Gp wrote a scrip for 30 days Lamisil......my thrush won't leave...so....when I can afford it...I'll do it.

Trout

PS...I am ebginning to look at Candida also...as a co-infection

------------------
Now is the time in your life to find the "tiger" within.
Let the claws be bared,
and Lyme BEWARE!!!
Iowa Lyme Disease Assoc.
www.ildf.info

 

quote:

---

Originally posted by troutscout:
I am on this protocol...been for 90 days...going on to 120...if I can afford it.

I herxed in the joints and neuroloically with this...also had some sweats.

But...that is all gone.

---

Trout, I have a question for you - what do you mean by "But...that is all gone"? Does this mean that those symptoms are better?

Both of my teenagers and myself are on this protocol too. We've only been on it for a little over a month.

So far - we are extremely fortunate - our prescription plan is covering the cost for us to use the diflucan.

We are hoping it works. So far we are all herxing, so hopefully that is a good sign.

Also - have you gotten to the point where you have started taking penicillin yet?

Thanks,
Art

 

quote:

---

Originally posted by Seeking Lyme Eradicator:
Strange. He says: "I recommend penicillin in early lyme disease"

Then he says: "In Germany, we have cefalosporine, roxithromycin, cotrim-TMPO, and Clarithromycin"

and then says "Then I recommend 20-30 days of any of the penicillins I mentioned"

Strange thing is none of the antibiotics he mentioned are penicillins. The only thing close to a penicillin is cefalosporine which is a generic name for a class of antibiotics and is the same as saying cephalosporins. One of the better cefalosporines (cephalosporins)is rocephin and also oral Cefixime. The other antibiotics he mentioned are roxithromycin (based on erythromycin), cotrim-TMPO (Bactrim), and Clarithromycin (based on erythromycin).

So we have a Dr. that doesn't seem to know what penicillins are. Hmmm.

I tried 200mg Diflucan for over 50 days and it did little to nothing for the late stage lyme. I previously tried many months of oral Cefixime (third gen. oral cephalosporin) with and without azithromycin and it eradicated all signs for about two months but it like many other antibiotics slowly stopped working.

I wonder if the same has happened to his 79 year old i.e. he feels much better due to the cephalosporin and wants to practice the power of positive thinking i.e. write the drug company and tell them I'm cured. I went through the same type feelings after starting azithromycin (I'm cured) Cefixime (I'm cured) Flagyl+azithromycin (I'm cured) but with everyone, a few months later the symptoms slowly returned.

---

Hi Chuckie, you're straight up busted.

[This message has been edited by 24bit (edited 30 July 2005).]
 

As regards Dr. Schardt: "I recommend smaller spectrum penicillins. The syphilis spirochete has not become resistant to
penicillin, and there's good evidence that borrelia, the lyme spirochete, has not either. In Germany, we have cefalosporine,
roxithromycin, cotrim-TMPO, and clarithromycin. These are all good
choices"

I repeat, none of these are penicillins. Also I've never heard of treating early lyme with cotrim-TMPO (bactrim). I do remember many years ago a European doctor proclaimed he was cured with roxithromycin plus bactrim but many months later we heard his symptoms returned while continuing to take the cocktail.

This current tale reminds me of that. First we hear 30 days, then we hear 50 days, then we hear 50 days and 30 days of his mystery german type penicillin and now we hear 50 days - 30 days repeated several times. It also reminds me of the Doctor who proclaimed Flagyl cured his daughter then we hear later double the length of treatment, triple the length, mix with other antibiotics and then his website disappears.

I'm praying one of these times we will hit upon a cure but have heard the above type tale many times over the years.
 

So, maybe this off and on treatment works this way: penicillin to hit the lyme, then diflucan to hit the candida, then repeat.

And what kind of penicillin are we talking about?

[This message has been edited by lou (edited 30 July 2005).]
 

There is no one protocol for everybody. Basically, what I think he meant by the antibiotics was narrower spectrum ones, not amoxicillin, not broad spectrum that ruin your digestive flora and through selective pressure will breed a wide range of resistant bugs. Those are my words but that's how I'd interpret what he says.

lou and others, no, he feels the diflucan is hitting the lyme. whether he's right or not i don't know but i'll tell you one thing, we are idiotic or else we believe pharmas' marketing, or both, when we think these drugs act only on a certain spectrum of organisms. i think the antifungals actually work on a wider spectrum. i found an abstract about the effectiveness of some in babesia. i've seen info about an antifungal working on chagas. there is something called miltefosine developed for cancer that they find helps leishmaniasis and i personally wish they would see what it does to borrelia. there are novel uses for old drugs.

I too am looking for a cure and its not diflucan. I'll keep you posted. I'm looking far afield of lyme researchers.

[This message has been edited by oxygenbabe (edited 30 July 2005).]
 

I find this very interesting because it happens that guaifenesin, promoted by Dr. St. Amand for the treatment of FMS, also inhibits this enzyme.

It has intrigued me for some time how much the initial effects of guai resemble herxes, and St. Amand's description of the cyclic nature of FMS symptoms resembles the cycles of Lyme symptoms.

I have come to believe that many, if not most, cases of FMS are caused by Lyme, and if the guai is indeed weakening the borrelia through its effect on P450, that would explain why it is so effective for some people.

I've read that many people experience a complete remission of symptoms with guai, some get moderate improvement, and some none at all.

I wonder if the cases of moderate to no improvement are impeded by co-infections.

I have been using guai for years, and I am one of those who have had moderate improvement.

I had stopped taking the guai since being on diflucan the last 2.5 weeks, but after reading about Dr. Schardt's theory, I started taking the guai again a couple of days ago, and have been herxing terribly.

This leads me to believe that it must be having some effect on the borrelia over and above that of the doxy.

Since I was only able to get a month supply of doxy, 200 mg/day, which I know is insufficient, I hope the guai (and the serrapeptase I'm taking) will make the little doxy I have more effective.

Anyway, I jsut wanted to share this interesting bit of info about guaifenesin.