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» LymeNet Flash » Questions and Discussion » Medical Questions » ? about orals and brain-blood barrier

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Author Topic: ? about orals and brain-blood barrier
lyme_suz
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Does anybody out there know which oral antibiotics are best for crossing the brainblood barrier?

I think as I am improving, I am realizing how bad
the neuro and brain is right now. Slow on the draw and judgement on little things is messed up. Like touching hot food with fingers to turn it over! Of course fingers are a little numb which is good, I guess in this case.

My daughter and I laugh til we cry about all this, which is better than crying. It is a miracle that I am taking care of my kids and nothing bad has happened yet.

My brain was never a steel trap, but I want it back!

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Areneli
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Large doses of Amoxycillin will cross to some extent; also minocycline and metronidazol. To small extent also doxycycline.
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livinlyme
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Dr B. says that third class cephlosporins cross the blood brain barrier.. Such As VAntin..which I was on for a great many months and it really helped a great deal....I NEED MORE NOW!!

Third-generation cephalosporins display an extended gram-negative spectrum at the expense of decreased activity against gram-positive bacteria. They are often used for treating gram-negative sepsis, as several cross the blood-brain barrier (cefotaxime, ceftizoxime, ceftriaxone). These drugs are also used in treating pseudomonal infections (cefoperazone, cefpiramide, cefsulodin, ceftazidime). Cefoperazone, cefmenoxime, and moxalactam are associated with coagulation problems and disulfiram reactions. Moxalactam is associated with a ten- to one hundred-fold risk of hemorrhagic complications, so bleeding complications should be suspected when using this drug.
here is a good link:
http://www.utmb.edu/otoref/Grnds/Microbiology-2004-0218/Microbiology-2004-0211.htm

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HOPE4290
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Dr. J in CT said that KETEK is good because it is one of the best orals at crossing the BBB.
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Areneli
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Ketek doesn't cross bbb. But often helps for neuroboreliosis anyway. Perhaps it is suffiecient to kill borrelia in blood vessels of the brain to obtain an improvement. But Ketek wouldn't go into brain tissue per se.
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Areneli
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My notes show that only i.v third class cephlosporins cross BBB.

Suprax, omnicef, ventin, cedax cannot do that.

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treepatrol
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The ``second generation'' of cephalosporins have expanded gram negative coverage besides having activity against gram positive further like the first generation.


Because there is considerable variation of activity among the drugs in the second generation, testing for susceptibility may be required to determine the drugs sensitivity to the organism it is planning to be used on.


Third-generation cephalosporins


Third-generation cephalosporins, a more recently developed form of β-Lactam antibiotics, are presently effective against most strains of S. pneumoniae, N. meningitides, and H. influenzae, and these antibiotic agents readily cross the blood-brain barrier. If a patient has a history of life-threatening β-Lactam intolerance, imipenem may be substituted1-4,11


Vancomycin
Vancomycin has demonstrated effectiveness against all presently known gram-positive strains, including S. pneumoniae and N. meningitides, but this agent is less reliable for it is not capable of crossing the blood-brain barrier in every case4.


Info on Roxithromycine
This is included separately as it is not approved for use in the US and it's hard to find stuff on it in English. It is a common antibiotic which is used for Lyme in Europe and Asia and it's safety has been tested in France. In Eastern Europe it was commonly used in combination with Bactrim for lyme. It is possible there are many co-infections of Staph there, which Bactrim is effective against. It is the only macroloid antibiotic which crosses the blood brain barrier.


Doxycycline seems to cross the blood-brain barrier better than other antibiotics on the list, so if your predominate symptoms are neurological, you may want to start with this one.
[confused]

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KrisKraft
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I took orals for two years, and recently moved to intramuscular, injectable, long-acting Bicillin. This REALLY improved my neuro issues.

Of the orals I've tried, Flagyl gets into the head best (used in combination with Biaxin).

KrisKraft

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Areneli
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Usage of Roxithromycine was a one big disappointment.

However there is an exception - a paper suggests that Roxithromycine in combination with Bactrim is somehow effective. Seems like bactrim potentates action of Roxithromycine.

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lyme_suz
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Thanks for the awesome replies.
I could follow them so that shows its I was going to say good day, but it is a good portion of day.

I am on septra, mino, with pulse of flagyl, so it was encouraging to hear that those two do cross the bbb. Tempted to switch to amox myself as my appt is not til middle of October. It's like I have a pharmacy full of drugs over here.!

Well, you have given me hope that the stupidity will dissapate. Do you ever notice that when you have a spurt of recovery that it hits you how bad it was/is?

Peace,
Suz

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