Clinical effects of fluconazole in patients with neuroborreliosis

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Clinical effects of fluconazole in patients with neuroborreliosis

 

 

 

http://www.geocities.com/playpub/TP-Diflucan.htm

 

 

Diflucan Protocol Articles

 

 

 

 

Table of Content

 

Diflucan Protocol 1

 

Clinical effects of fluconazole in patients with neuroborreliosis. 1

 

A New Approach to Chronic Lyme Disease. 1

 

 

 

 

 

 

 

Clinical effects of fluconazole in patients with neuroborreliosis.

 

Eur J Med Res. 2004 Jul 30;9(7):334-6., Schardt FW., Betriebsarztliche

Untersuchungsstelle, Bayerische Julius-Maximilians-Universitat,

Wurzburg, Germany. Fritz.Schardt

 

Eleven patients with neuro-borreliosis had been treated with 200 mg

fluconazole daily for 25 days after an unsuccessful therapy with

antibiotics. At the end of treatment eight patients had no borreliosis

symptoms and remained free of relapse in a follow-up examination one

year later. In the remaining four patients, symptoms were considerably

improved. At the end of therapy immune reactivity (IgM+) disappeared

in three patients. Since borrelia spp. are almost exclusively

localised intracellular, they may depend on certain metabolites of

their eucaryotic host cell. Inhibition of P450 and other cytochromes

by fluconazole may incapacitate Borrelia upon longterm exposure.

 

PMID: 15337633 [PubMed - indexed for MEDLINE]

 

 

 

 

Clinical effects of fluconazole in patients with neuroborreliosis.,

Schardt FW., Betriebsärztliche Untersuchungsstelle, Bayerische

Julius-Maximilians-Universitat, Wurzburg, Germany.

Fritz.Schardt, , Eur J Med Res. 2004 Jul

30;9(7):334-6, PMID: 15337633 [PubMed - indexed for MEDLINE]

 

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

5337633 & dopt=Citation

 

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=pubmed & dopt=Abstra\

ct & list_uids=15337633 & query_hl=1

 

 

 

A New Approach to Chronic Lyme Disease

 

ImmuneSupport.com, 05-11-2005, By Jill Neimark

 

http://www.immunesupport.com/library/showarticle.cfm/id/6431/searchtext/schardt/

 

In May of this year I sat down at the beautiful Essex House on Central

Park South, with a German physician specializing in internal medicine,

Fritz Schardt. Dr. Schardt, who is associated with the University of

Wurzburg in Germany, published an interesting pilot study in the

European Journal of Medical Research in July of 2004 on the use of an

antifungal drug, fluconazole, in treating chronic, advanced lyme

disease. This pilot study examined 11 patients with chronic lyme. Dr.

Schardt has slowly refined the protocol since then, and believes it

holds great promise in treating this difficult condition—which is

often misdiagnosed as chronic fatigue or fibromyalgia. Here follows

our interview:

 

Jill Neimark (JN): What made you think of using diflucan, an

antifungal, to treat lyme disease?

 

Dr. Fritz Schardt (FS): I was actually my first patient. I got lyme

disease in 1989, and was given two weeks of doxycycline. Our country

follows the protocols set by yours, so that's what is generally

recommended. I now know that was very inadequate and I do not think

doxycycline should be used in early lyme disease at all. It is only

bacteriostatic, meaning it inhibits the bacteria but does not kill them.

 

JN: I know, the same thing happened to me. At the doses they

recommend, it also does not penetrate the central nervous system. I

had a fever, stiff neck and bullseye rash. The stiff neck means it was

already in my nervous system. Therefore I probably needed six to eight

weeks of doxycycline at double the dose I was given. Higher doses will

penetrate the CNS.

 

FS: Right. I recommend penicillin in early lyme disease.

 

JN: Amoxicillin is given here. Is that what you recommend?

 

FS: No, that's broad spectrum, so you end up killing many bacteria,

including necessary ones in your gut. I recommend smaller spectrum

penicillins. The syphilis spirochete has not become resistant to

penicillin, and there's good evidence that borrelia, the lyme

spirochete, has not either. In Germany, we have cefalosporine,

roxithromycin, cotrim-TMPO, and clarithromycin. These are all good

choices. They should still be taken for 20-30 days.

 

JN: Okay, well, you took doxycycline so you ended up with chronic lyme

disease. What happened then?

 

FS: I was sick for 18 months. I was given intravenous rocephin several

times. I would feel better, but then once I stopped taking the

antibiotics, I relapsed. I was often bedridden and I thought I was

ready for the wheelchair. Then, I developed a fungal infection,

possibly because of all the antibiotics. So I was put on diflucan.

This was around 1990. It was a new drug that was being used mainly for

opportunistic fungal infections in AIDS patients.

 

JN: And what happened?

 

FS: I got better. But I only stayed on it for two weeks at first, and

then I got worse again. So I went back on it for 30 days, and I got well.

 

JN: What was the dose?

 

FS: I took 100 milligrams twice a day.

 

JN: Are you completely well?

 

FS: I am very active and energetic and I feel quite well. I have since

competed in athletic events and won them. However, I do have an

occasional heart arrhythmia that I believe may be due to permanent

damage from the spirochete.

 

JN: Tell me your reasoning as to why diflucan might work in chronic lyme.

 

FS: There are several reasons. First of all, it inhibits an enzyme

called cytochrome P450. This is an enzyme that your liver, for

instance, uses to detoxify chemicals and drugs. Borrelia has a very

primitive p450 defense, so if you inhibit it, it is easily weakened.

Therefore I believe that diflucan inhibits the growth and replication

of borrelia. It does not necessarily kill it. In addition, it

penetrates well into the cells and into the nervous system and brain,

where borrelia may hide.

 

JN: What is your current protocol?

 

FS: I recommend 200 milligrams a day, for 50 days. There are now 200

milligram pills available, so once a day is fine. Then I recommend

20-30 days of any of the penicillins I mentioned. You may have to go

through several cycles of this protocol. You must also be very aware

of other drugs that act on the p450 enzyme system, specifically a

subset that inhibits CYP3A4. You should not be taking any of these

drugs at the same time as you take diflucan.

 

JN: What are some of these drugs?

 

FS: There are many, and it's best to check with your doctor. Some

common ones are erythromycin, amitryptylin, midazolam, Lovastatin, and

others.

 

JN: I hate antibiotics. Do you have to take the penicillin?

 

FS: I understand, many lyme patients come to hate antibiotics because

they have to take so many of them for so many years and are still ill.

In fact, I also was made ill by the antibiotics.

 

JN: They really disrupt your digestion.

 

FS: Right, that was my problem.

 

JN: So, this protocol is your best one-two punch against borrelia, but

you don't have to take the antibiotics if you truly hate them.

 

FS: Right. In addition, diflucan has a slow half-life so it can slowly

build up in your bloodstream. Sometimes patients call me after a few

weeks and say they are feeling very ill on the protocol. Perhaps it's

a herxheimer, or perhaps it's that the levels of diflucan are higher

than they can tolerate. So I say, take a 3 or 4 day pause, and then go

back on the protocol. This is perfectly acceptable.

 

JN: What happens if you have a weak p450 system? Have any of your

patients have raised liver enzymes from the diflucan?

 

FS: I have been lucky, not one of my patients have had raised enzymes.

It is generally well tolerated. If it is a problem, however, you can

lower the dose of diflucan. This would be overseen by your doctor. I

recommend 100 milligrams in pediatric cases.

 

JN: How many patients have you treated now?

 

FS: At least eighty.

 

JN: What is the most difficult case you've had?

 

FS: I have one 75-year-old patient who has had lyme for 18 years. He

was very ill. He has had to do this cycle of diflucan and penicillin 3

times. He is much, much better. In fact, he's so happy with his

improvement he called the drug manufacturer to tell them they need to

run a publicity campaign to promote diflucan for chronic lyme disease.

 

JN: Some patients on some internet groups are adapting your protocol,

probably in concert with their doctors, and I'd like to know what you

think of this. They are suggesting staying on diflucan for 9 months,

and some of them are adding in low-dose minocycline. Are you aware of

this?

 

FS: No, I am not aware of this.

 

JN: What do you think of the idea?

 

FS: I believe in the narrow-spectrum penicillins for borrelia, not the

cyclines.

 

JN: What about 9 months?

 

FS: That remains to be seen. Perhaps, like tuberculosis, some patients

will need to be on diflucan at least six months or more. Borrelia is

a very sophisticated organism, and one of the few bacterium with two

cell membranes. There is much we still have to learn about it.

 

© Jill Neimark, 2005.