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» LymeNet Flash » Questions and Discussion » Medical Questions » Bacterialcidal vs. Bacterialstatic and (lab serology tests) Sensitivity/Specificity

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Author Topic: Bacterialcidal vs. Bacterialstatic and (lab serology tests) Sensitivity/Specificity
LymeDACnow
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Hi,

I need a clear concise explaination. My minds just not doing it on it's own right now. any help is greatly appreciated!

--------------------
"Courage is the mastery of fear-not the absence of it."-Mark Twain

Still trying hard to be brave...Deb

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adamm
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bacteriostatic agents inhibit bacterial reproduction, but do not

kill the organisms that are exposed to them, whereas

bacteriocidal ones actually waste the bugs


sensitivity- measure of incidence of actual positive cases being

picked up by a test


specificity- measure of incidence of the thing the test is

supposed to detect actually being there in cases in which

positive results are obtained. (rate of occurrence of positives

being "true.")


I'm not sure about its specificity, but I know that, as a Lyme test,

the ELISA has horrible sensitivity.

[ 08. January 2008, 02:18 PM: Message edited by: adamm ]

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david1097
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The previous post was pretty concise but I'll add a comment about what is sometimes perplexing regarding the two types of antibiotics...

Why would anyone want to use a bacteristatic drug rather than a bacteriacidal one if it does not kill the bacteria?

Many infections are very fast growing. They grow so fast as to not even allow the immune system to catch up. The drugs that stop the bacteria from replicating can allow the immune system to catch up and overtake the infection.

Also, bacteristatic drugs may be the only ones available for a particular type of bacteria. In addition, bacteriostatic in combination with bactericidal drugs can minimize the the bacteria developing a resistance to the bacteriacidal drug.

This is not an answer to the original question but I am pretty sure it will be one of the next questions asked.

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LymeDACnow
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Thank you both so much! And David you did read my mind that was my next question! I have one more.

How do you get Herx's with bacteriostatic abx? (I've had severe herx reactions with Doxy in the past.) If a herx is from die off of bacteria ...

Hope someones around to answer this one!

Thanks again!

--------------------
"Courage is the mastery of fear-not the absence of it."-Mark Twain

Still trying hard to be brave...Deb

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LymeDACnow
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quote:
Originally posted by cave76:
****How do you get Herx's with bacteriostatic abx****

Ah, that's the question! [Smile]

That's been asked and answered here before. Well, asked.

Maybe someone can come and give a really good explanation?

I sure hope so ... now I'm intriqued (by my own question)

--------------------
"Courage is the mastery of fear-not the absence of it."-Mark Twain

Still trying hard to be brave...Deb

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ldfighter
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Dr. B's guidelines say doxy may be bactericidal in higher doses (300-600mg/day). Also, studies suggest taking plaquenil with doxy can make doxy more bactericidal.

There's debate as to whether true herxes are caused by toxins from dead bacteria or immune system activation (cytokines like TNF-alpha), or both. I might be wrong about this, but my understanding is that those cytokines may be elevated even with a bacteriostatic drug, so you can get a classic flulike herx with something like doxy. I know I did.

Pound MW, May DB. Proposed mechanisms and preventative options of Jarisch-Herxheimer reactions. J Clin Pharm Ther. 2005 Jun;30(3):291-5.

"...JHR often occurs with the treatment of spirochete infections. However, the mechanism by which the reaction takes place is not clearly defined.

CONCLUSION: Studies suggest with conflicting evidence that the JHR is caused by release of endotoxin-like material from the spirochete as well as cytokine elevation in the body. It appears the type of drug and the rate of spirochete clearance from the body have little effect on the incidence of the reaction. Many pretreatment options have been explored with limited efficacy with the exception of anti-tumour necrosis factor antibodies."

PMID: 15896248 [PubMed - indexed for MEDLINE]

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LymeDACnow
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Thanks Idfighter! I'm planning to ask this of my LLMD next visit. But this makes sense. All I really know is I had severe neurological symptoms on a 3 wk trial of doxy before confirmed dx of LD.

--------------------
"Courage is the mastery of fear-not the absence of it."-Mark Twain

Still trying hard to be brave...Deb

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