LymeNet Flash: Why have we never heard of these TWO abx combo-roxithromycin plus co-trimoxazole

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»	LymeNet Flash » Questions and Discussion » Medical Questions » Why have we never heard of these TWO abx combo-roxithromycin plus co-trimoxazole

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Topic: Why have we never heard of these TWO abx combo-roxithromycin plus co-trimoxazole

Marnie
Frequent Contributor (5K+ posts)
Member # 773

posted

"Oral treatment of late borreliosis with roxithromycin plus co-trimoxazole"

http://home.pon.net/caat/lyme/txtfiles/gasser.txt

How did I run across the above?

The treatment - Augmentin + antihistamine - given to a young 9 year old girl with H1N1 - stirred my interest - re: beta lactamase i.e. need to inhibit...

Inhibiting beta lactamase (an enzyme) appears to prevent the destruction of the antibiotic. Augmentin is amoxicillin + clavulanate potassium. The latter is a beta lactamase inhibitor.

"An enzyme called beta-lactamase is present in many different types of bacteria, which serves to 'break' the beta lactam ring, which effectively nullifies the antibiotic's effectiveness."

But...researching further...we need the abx to cross the BBB (very few do/in any appreciable amt.)...which the above combo in the link looks to do.

Note...

Roxithromycin -

"This is the ONLY macrolide antibiotic that crosses the blood brain barrier (BBB)."

Roxithromycin is a semi-synthetic macrolide antibiotic. It is used to treat respiratory tract, urinary and soft tissue infections. Roxithromycin is derived from erythromycin, containing the same 14-membered lactone ring. However, an N-oxime side chain is attached to the lactone ring.

Roxithromycin is available under several brandnames, for example, Roxl-150, Roxo, Surlid, Rulide, Biaxsig, Roxar, Roximycin, Tirabicin and Coroxin.

***Roxithromycin is NOT available in the United States.***

(But "Google" it on the internet...)

Roxithromycin has also been tested to possess antimalarial activity.

The other one in the combination, co-trimoxazole, is known as: Septra (GSK), Bactrim (Roche), and various generic preparations.

(en.wikipedia links)

OR...what about this approach (very new!)?

(Currently being tried as an adjunct for HIV treatments too):

http://tiny.cc/kbzT4

Because...Both β-cyclodextrin and Methyl-β-cyclodextrin (MβCD) ***remove cholesterol*** from cultured cells.

Lots of interesting other links, such as:

http://tiny.cc/D0Pyb

And this comment:

"Title: B-cyclodextrin derivatives and their use against anthrax lethal toxin"

And this:

"Interaction of the noncovalent molecular adapter, ***beta-cyclodextrin***, with the staphylococcal

*alpha-hemolysin* pore"

Because...

"(AE001125) *alpha-hemolysin* (hlyA) Borrelia burg..."

Recent new patent combining these:

CoQ10 and beta cyclodextrin:

http://www.nutraingredients.com/Research/CoQ10-gets-formulation-boost-in-beta-cyclodextrin

"Lipid rafts are specialized plasma membrane microdomains enriched in cholesterol and sphingolipids that serve as major assembly and sorting platforms for signal transduction complexes.

Constitutively expressed heat shock proteins Hsp90, Hsc70, Hsp60, and Hsp40 and a range of neurotransmitter receptors are present in lipid rafts isolated from rat forebrain and cerebellum.

***Depletion of cholesterol*** dissociates these proteins from lipid rafts."

http://www3.interscience.wiley.com/journal/110528790/abstract?CRETRY=1&SRETRY=0

In addition,

"We have previously demonstrated that when macrophages are incubated with either bovine serum albumin

or cyclodextrin (cholesterol acceptor particles),

***expression of CD36 is decreased.***

http://www.jbc.org/content/277/26/23582.full.pdf

CD36 is a "protein binder" (ligand) which is found on many various cells.

Okay...can beta cyclodextrin block CD36 on cells (our damaged antibodies too?) and then we can hit Bb with an abx that does work?

The 7 sugar ring, beta cyclodextrin + an abx.?

Any OTC product contain it? Yup.

http://www.illpumpyouup.com/universal/hard-fast.htm

Any Rxs contain it?

Yup...several...see table 1-4:

http://tiny.cc/rOleO

Beta cyclodextrin appears to make whatever it is

added to...

more effective.

Basically the combination maybe reducing the cytokines released from the infected cells while hitting the pathogen simultaneously.

Our antibodies to Bb's OspB are damaged and so we need abx.

OR...a cholesterol lowering drug with a form of beta cyclodextrin (like the combination of Ezetemibe and 2-Hydroxypropyl Beta Cyclodextrin.

We gotta tame down the "alternative route" our body is taking to try to destroy Bb (via increasing ROS = "fry" Bb's cell walls) which doesn't work because Bb can rebuild "his" cell walls.

The CWD form can be "finished off" via osmotic pressure changes or ultrasound.

BTW...CD46 in lupus too:

"To our knowledge, this is the first demonstration that CD36 expression is enhanced by plasma from patients with an autoimmune disorder." 2009

http://www.ebmonline.org/cgi/content/abstract/234/3/354

[ 10-17-2009, 05:19 PM: Message edited by: Marnie ]

Posts: 9426 | From Sunshine State | Registered: Mar 2001 | IP: Logged |

Lymeorsomething
Frequent Contributor (1K+ posts)
Member # 16359

posted

That's a good find, Marnie. It may be worth a shot for those who do not want to go the IV route.

--------------------
"Whatever can go wrong will go wrong."

Posts: 2062 | From CT | Registered: Jul 2008 | IP: Logged |

bettyg
Unregistered

posted

marnie,

could you show the names of the 2 abx in subject line? would help us all ... thank you [Smile]

IP: Logged |

kadee
LymeNet Contributor
Member # 21199

posted

This combination is pretty popular in Germany, known as the "Gasser-Therapy", despite the fact, that it doesn't work in vitro for borrelia.
Many had good results with it - so did I.

The combination usually taken is:
Roxithromycin (150 mg twice daily) and trimethoprim/sulphamethoxazole (150 mg twice daily).

Trimethoprim is better tolerated than Cotrimoxazole.

[ 10-19-2009, 06:19 PM: Message edited by: kadee ]

Posts: 269 | From Germany | Registered: Jul 2009 | IP: Logged |

n.northernlights
LymeNet Contributor
Member # 17934

posted

Here is a german webpage where they mention gassler-theraphie http://www.zeckenbiss-borreliose.de/behandlung.html you can run it through google translate

Posts: 366 | From Europe | Registered: Nov 2008 | IP: Logged |

Amanda
Frequent Contributor (1K+ posts)
Member # 14107

posted

Unfortunately, I don't think you can purchase roxithromycin in the US

--------------------
"few things are harder to put up with than the annoyance of a good example" - Mark Twain

Posts: 1008 | From US | Registered: Dec 2007 | IP: Logged |

seibertneurolyme
Frequent Contributor (5K+ posts)
Member # 6416

posted

Here is a source for roxithromycin -- see brand name Rulide

http://www.allpharmacymedicines.com/antiobiotics

Bea Seibert

Posts: 7306 | From Martinsville,VA,USA | Registered: Oct 2004 | IP: Logged |

coltman
LymeNet Contributor
Member # 21272

posted

This is such old news . I dunno why you didnt run into this article before

Andt cotrimoxazole synergistic effect with other abx is well known

Posts: 856 | From MA | Registered: Jul 2009 | IP: Logged |

Marnie
Frequent Contributor (5K+ posts)
Member # 773

posted

Somehow...I haven't yet downloaded all of the websites on the internet, but sure feel like I have!

Erythromycin has not been considered a "front-line" treatment for lyme.

"The role of the newer macrolides in the treatment of Lyme Disease needs further assessment.

Erythromycin has been regarded as ineffective, despite its good in vitro sensitivities."

http://www.prohealth.com/library/showarticle.cfm?libid=8441

"He" and I disagree on the need for Mg.

My point of view is based on:

http://www.john-libbey-eurotext.fr/e-docs/00/03/FD/D1/article.phtml

Huge difference between in vitro and in vivo - apparently.

In vivo (in a live animal)...other factors maybe at play that we are not aware of...changing the expected reactions.

Thanks Kadee for the additional info.

And Bea...yea, I know...;-)

Posts: 9426 | From Sunshine State | Registered: Mar 2001 | IP: Logged |

kidsatlast
LymeNet Contributor
Member # 4308

posted

Thanks, Marnie. This thread is very useful.

Posts: 156 | From MA | Registered: Jul 2003 | IP: Logged |

psano2
LymeNet Contributor
Member # 11711

posted

I'm using Roxy and am having a good response to it. I recently increased my dose to 900mg/day (450mg Bid) and herxed more strongly in spite of seeming to have plateaued at 600mg/day.

I'm taking it w/Malarone and Cloroquine and am feeling great.

Posts: 975 | From California | Registered: Apr 2007 | IP: Logged |

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