posted
According to the recommendations of Prof.Gasser should Bactrim be taken 5-6h after intake of roxithromycin . Anyone knows why, or can it be taken together?
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MariaA
Frequent Contributor (1K+ posts)
Member # 9128
posted
I'm interested in trying the Gasser Protocol again (it helped me in the past) but haven't read up on the info in quite a while- do you have links to any websites that list the recommended dosages and recommended protocol?
For Americans: I have a thread here (do a search, I don't have link handy) that listed about 5 overseas pharmacies that'll mail roxithromycin with a prescription (some might even do it without, though there's a crackdown on those places going on in the US now, nothing to do with roxithromycin itself). It's not TOO expensive (but not cheap either).
Stefan, in the Gasser Protocol, is the dosage of Bactrim DS TWO tablets twice a day (ie double what's normally done)? I seem to remember reading that somewhere but I can't find dosing info now.
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posted
THE LANCET, VOL. 336, (NOV 10, 1990) p. 1189f.
Oral treatment of late borreliosis with roxithromycin plus co-trimoxazole
SIR, - Early, but not late, Lyme borreliosis has been successfully treated with oral antibiotics such as penicillins, erythromycin, and tetracycline. The possibility of an oral treatement is desirable, especially in view of the great difficulties that arise with long-lasting intravenous treatment in third-world countries.(1, 2) Various workers have shown relapses and failure of treatment in late Lyme borreliosis(adrodermati**** chronica atrophicans, arthritis, neuroborreliosis) even with high doses of intravenous penicillin or ceftriaxone. (2, 3) Treatment that is both orally applicable and effective is certainly needed.(2) Co-trimoxazole is a powerful antibiotic combination to which many microorganisms respond, including the spirochaete Treponema pallidum. Furthermore, it has been show that the new macrolides(such as roxithromycin) show a remarkable antimicrobial activity angaint B burgdorferi.(4,5) It is noteworthy that the blood/brain barrier is highly permeable to roxithromycin. A 30-year-old man infected with B burgdorferi 7 years ago was successfully treated with a combination of roxithromycin(300 mg twice daily) and trimethoprim/sulphamethoxazole(320 mg/1600 mg twice daily) after both intraveous penicillin(20 million IU daily ober 3 weeks) and later ceftriaxone 2 g twice daily for 3 weeks) had failed (figure {not included} ). Both intravenous penicillin and ceftriaxone reduced the symptoms transiently, while IgG remained positive. However, shortly after a 3-week course of roxithromycin/co-trimoxazole all symptoms disappeared and a recent assessment of IgG revealed a negative titre. The recovery of the patient's neurological disorders was strikingly rapid, possibly because of the high permeability of the blood/brain barrier to roxithromycin. Thus, albeit in only 1 patient, we have shown successful oral treatment of late Lyme borreliosis with a combination of roxithromycin and co-trimoxazole.
Robert Gasser, University Laboratory of Physiology, Osford OX1 3 PT, UK
Johann Dusleag, University Medical Clinic, Graz, Austria
1. Steere AC, Malawista SE, Newman J, Spieler PN, Bartenhagen HN. Antibiotic therapy in Lyme disease. Ann Intern Med 1990;93:1-8.
2. Weber, K, Preac-Mursic V, Neubert V, et al. Antibiotic therapy of early European Lyme borreliosis and acrodermatitis chronica athrophicans. Ann NY Acad Sci 1988; 325-45
3.Dattwyler RJ, Halperin JJ, Volkman DJ, Luft BJ. Treatment of later Lyme borreliosis - randomisesd comparison of ceftriaxone and penicillin. Lancet 1988: i: 1191-94
4. Preac-Mursic V, Gross B, Suiss E, Wilske B, Schierz G. Comparative antimicrobial activity of the new macrolides against Borrelia burgdorferi. Eur J Clinical Microbiol Inf Dis 1989; 8: 651-53
5. Steere AC, Grodzicki RL, Kornblatt AN, et al. The spirochaetal etiology of Lyme disease. N Engl J Med 1983; 308: 733-40.
_________________________ [note from poster] In response to this article a few weeks later there was an article from two physicians of the University Hospital of Frederiksberg, Denmark (Departement of Rheumatology and Clinical Microbiology) entitled with: Late treatment of chronic Lyme arthritis. They discussed a similar case and also tried this combination treatment of Gasser and Dueslag. They also were successful and came to the conclusion that, "combined therapie with roxithromycin and co-trimoxazole may prove effectiv in chronic Lyme arthritis where conventional antibiotics have failed."
MariaA
Frequent Contributor (1K+ posts)
Member # 9128
posted
Thank yoU!
So they're talking about one case (I know they actually based the protocol on many more) in which the dosage was 600 mg/day roxithromycin (or rather, 300 mg twice a day), and four Bactrim DS tablets per day in the form of two twice a day (which is hard for some people to tolerate, though not for me). I think there are risks to Bactrim DS even if you're not allergic to it, so please research those before using high doses. It can do kidney damage I believe, and testing your blood chemistry (ie the 'liver enzymes' test in the US, which actually tests more than the liver) seems essential.
I'll probably switch over to this next, I have used it in the past and think I made some gains on it at the time. I'm currently battling relapses unless I use Bactrim, which I now use in the double-doses. I can't tell if it's controlling babesia (my most likely problem ) or bartonella (as I have the characteristic foot pain).
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