Boston University Medical Center, 650 Albany Street-8th Floor, Boston, MA 02118, U.S.A. [email protected]
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.
Posts: 77 | From USA | Registered: Feb 2006
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Thanks for posting this, BlueSkyFaith. I have just started this protocol (about a week) and already am feeling improvement. I had been on doxy for a month and tetra for a month with little improvement, other than relief of massive fatigue.
I am seeing an LLMD who is very up on Dr. D's new protocol and thus is following it. Thanks again.
Katie
Posts: 9 | From Massachusetts | Registered: Feb 2006
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