A 60 year old female came to my office over one year ago. She had been struggling with fibromyalgia, ulcerative colitis and depression for decades. She provided a multi-page list of symptoms.
The highlights were: fatigue, pain, loss of sensations, symptoms related to special senses--hearing-vision, AND rather profound cognitive deficits. She was on a list of nutritional supplements which filled a full page. She had been a highly functional professional in the past.
She suspected she might have chronic Lyme disease; this diagnosis had never been made.
She brought sheaves of lab work which was unhelpful. I found her to have an elevated rheumatoid factor-(174)-normal less then 14. Her white blood cell count was minimally depressed, 3.7. Her CD57 was slightly depressed, 50. Special Clongen labs showed positive 39 and 23 Western Blot bands. A wet mount exam showed round extracellular bacteria.
The initial physical exam revealed a fairly profound peripheral neuropathy.
Her treatment was complex; she was prescribed a number of antibiotic combinations. I will not discuss all the antibiotics she has taken over time, except to say that she was aggressively treated for the known co-infections.
One drug which has been particularly efficacious is Cipro. When this was discontinued she has back-pedaled everytime: symptoms which had improved return.
When I started treating chronic Lyme in a serious way, several years ago, I was sent a paper written by Dr. Jemsek. He described a Lyme regimen in which he used Cipro with Doxycyline. He stated that the two drugs worked via an intracellular mechanism and were synergistic.
After reading this I jumped on the Cipro train. Old data on MICs(minimal inhibitory concentrations), showed that Cipro was reasonably active against Bb.
I used Doxy and Cipro and then began switching to Cipro and Amoxicillin.
Doxycyline works by inhibiting protein synthesis within bacteria. Cipro works by inhibiting DNA gyrase necessary for DNA synthesis.
Rather than using two intracellular antibiotics I combined a cell wall inhibitor with an intracellular antibiotic with the belief that this might be more effective. This sort of thinking was espoused by many LLMDS if not this particular combination.
In those days I wasn't giving Bartonella much thought, but it is well known that Cipro has activity against Bartonella.
I had years of experience with Cipro prior to launching into the the waters of Lyme. The tendon rupture issue is much exaggerated in my experience.
What I know about Cipro is that it is a very powerful antibiotic. It has been claimed that oral Cipro can provide tissue antibiotic levels rivaling that of IV antibiotics. Cipro is one of the few antibiotics able to cross the prostate/blood barrier. Very high tissue concentrations--in many organs, are achieved with oral doses.
As I look back at charts of patients treated with Cipro I find that many had excellent responses. Then I stopped using Cipro for the most part: it was not an LLMD recommended drug.
As of late I am using the drug more. It provides high tissue concentrations, is active against Bb- and also works for Bartonella-or Bartonella syndrome.
I start low: 250 mg daily-- and then increase to 250mg twice daily. This relatively low dose is frequently effective. Patients are warned about tendon/muscle pain. I generally institute it when these pains have already been controlled by other antibiotics. I have never seen a tendon rupture.
As aside, Cipro is also active against Mycoplasmas and Chlamydia pneumonia.
It works. Posted by Lyme report: Montgomery County, MD at 6:06 AM
Posted by Terminator (Member # 27328) on :
On the link above FunkOdyssey in the comments provided a study claiming that Cipro have in vitro activity against Bb (in "In vitro activities of fluoroquinolones against the spirochete Borrelia burgdorfer")
Since I have never treated my Lyme (just got IgeneX results) I'm scared that taking the 10 days of Cipro could push the bad guys into cystic forms.. In other words I would like to arrive at my LLMD and be nearly an antibiotic virgin. Is this a legitimate concern?
On the other hand perhaps taking that Cipro would work as some kind of antibiotic challenge, which would get me a clearer picture when I go my coinfections testing (and perhaps rerun the Lyme panel- I almost got the CDC criteria the first time, and that would help for insurance purpose..)
As far as Bart, I suppose it would help to test positive but 10 days would be very unlikely to erradicate it?
Btw I'm planning to take a 14 days break between the end of any antibiotics and the labwork
Posted by Remember to Smile (Member # 25481) on :
Dear Terminator, Please set an appt with an experienced LLMD or LLDO so you can achieve long-term remission of your chronic Lyme neuroborreliosis, Babesiosis, and Bartonelliosis.
It's not wise or prudent to consider self-medicating yourself with abx now based on some web searches. LD is VERY complex!
Successful LLMDs now know that Babeosis MUST be cleared first, then Bartonella, then Borreliosis.
LD is not a DIY project. ILADS-trained LLMDs keep up with the latest treatments and share info with each other on what works best for patient health.
In another post you'd indicated the ability to travel for care. Please focus on getting an appt with an LLMD who's gotten at least 3 people into long-term remission.
You may also wish to consider attending the LDA Conference in Philly and/or the ILADS Conf in NJ. Both are this October and their agendas look great!
Best wishes, Smile
[ 08-17-2010, 04:35 AM: Message edited by: Remember to Smile ]
Posted by NMN (Member # 11007) on :
Cipro is very broad spectrum and despite what others have said here I believe it can have strong action against all infections including inter cell BB.
Cipro was after all derived from anti malarial Chloroquine and we do not all have babesia. Some have other parasitic forms which can be treated with quinalones.
It is excellent for Bartonella. I would recommend you get guidance with your treatment from an ILADS LLMD also.
Many people get scared off by quinalones but I think amny are missing out on excellent weapons against these infections. I would not be here without them.
Posted by sixgoofykids (Member # 11141) on :
quote:Originally posted by NMN: Cipro is very broad spectrum and despite what others have said here I believe it can have strong action against all infections including inter cell BB.
What I posted is not my personal opinion, rather that of my LLMD who has over 20 years of experience.