Antibiotics A PILL FOR EVERY ILLNESS Do antibiotics help or hinder M.E patients? Maggie leathely, a former health visitor, considers the evidence. M.E recently grabbed the headlines when a woman who had been seriously ill for five years made an apparently miraculous recovery, (daily express, 25 June) Julie Copley, a former nursery nurse in her early forties, suffered severe Neurological symptoms and considerable pain and needed to spend much of her time in bed and could walk only with difficulty. After extensive investigations she had eventually been diagnosed with M.E Then a serious infection turned out to be a blessing in disguise. In April 2001 Julie had severe abdominal pain and high fever so bad that she had to be admitted to hospital. There she was given intravenous antibiotics to treat a suspected bacterial infection, astonishingly within 72 hours not only was Julie recovering from the abdominal infection, but all her symptoms of the past five years were beginning to recede. She said "as soon as my temperature began to go down, the fatigue went". Julie is now overjoyed and considers her self to be cured but in need of rehabilitation and physiotherapy, after five years of illness, she is well aware of the possibility of relapse but so far she is making good progress with fitness. Dr Ronald Strachan another M.E sufferer discovered that antibiotics helped him by chance in 1997 when he was suffering from a severe chest infection, for which his doctor prescribed a course of KLARACID or (clarithromycin). He found after two weeks of treatment, not only was his energy level much higher than usual he also felt less toxic. A second month of taking this drug brought similar improvements (another antibiotic, vibramycin, had no effect.) Dr strachan then contacted Dr garth nicolson, a researcher into mycoplasma infections in CFS patients in the USA. he was tested for mycoplasma and the result came back positive, so he took an 18 month course of treatment, following Dr nicholson's protocol ( for more details see Dr nicholson's website details in the reference list at the end of this article.) Dr strachan said "although I am not cured I have seen a lot of improvement in the general severity of my illness as a result of this treatment" . he now takes antibiotics when he needs them for his chest which still troubles him, he points out that not everyone with M.E can benefit from antibiotic treatment and he cautions that anybody who suffers from allergies or gut problems be especially vary. so why might antibiotics be helpful for some people with M.E.? Dr sarah Myhill, who has treated hundreds of sufferers, points out that it all depends on what is causing the illness, In some cases the cause may be a low -grade bacterial infection, in which case antibiotics would be the appropriate treatment. in other cases there may be a chronic viral infection, for which antibiotics are of no value unless bacteriological complications arise (e.g. flu followed by pneumonia). a second problem lies in distinguishing weather an infection is indeed the primary cause of illness or is a secondary consequence of poor immune function. some doctors disagree as to the usefulness of directing treatment at a secondary or opportunistic infection, which is only a problem because the patient is already ill. however Dr Myhill believes that 'eradication of a low grade or persistent infection is one way to reduce the load on your immune system, and thus improve tha M.E'. some possible culprits chlamydia pneumoniae This common bacterium should not be confused with it's better known, sexually transmitted relative (although Dr Myhill points out that the latter could also cause chronic fatigue). chlamydia pneumoniae is widely known as a cause of respiratory infections such as coughs, colds and bronchitis. some researchers suspect it may also be involved in a number of chronic diseases. Larger scale research is needed before it will be possible to judge how significant this organism is in M.E.' chlamydia pneumoniae is not easy to recognise. it can be identified in body fluids using specialist molecular tests, but these may not be available locally on the NHS. These tests can give false positives so it is important to ask how specific the test is. Eradication of the organism may require several different antibiotics. helicobacter pylori this is a bug now known to be responsible for causing stomach ulcers. In some cases it is even implicated in the development of cancer. thought that up to 40% of the population harbour this bacterium without becoming ill - but for those who are susceptible, it can have very serious effects. The test for helicobacter pylori should now be generally on the NHS. It would be reasonable for anyone who has stomach problems as part of their M.E., or whose family members have had stomach disorders such as gastric ulcers, to ask their GP to run a test for it. like any chronic infection helicobacter can drag down a person's health, and for this reason Dr Myhill recommends that people with M.E. should have this infection treated conventionally using a combination of anitbiotic therapy with an antacid and sometimes also a bismuth compound such as denol. mycoplasmas These are not strictly bacteria but are a special form of micro-organism which is like a bacterium but without a cell wall. there are many different strains of mycoplasmas, and many of them are found in healthy individuals in the mouth, nose, gut or vagina. These are not a problem, but certain strains are able to penetrate into the blood cells and other body tissue. some doctors in the USA have found that up to 60% of their patients with CFIDS ( the equivalent of M.E. ) are infected in this way, and claim to have had good results with long , sometimes pulsed (e.g. six weeks on six weeks off ) courses of the right antibiotics. This treatment is still not widely recognized by doctors in Britain, and studies of UK M.E. sufferers have not found the same prevalence of the organism. sensitive molecular testing for mycoplasmas are not available within the NHS or PHLS (public health laboratory service ), but can be obtained privately. lyme disease and brucellosis These are extremely rare in Britain, but can cause chronic infections which have similar symptom profile to M.E. which respond to treatment with antibiotics. Lyme disease is transmitted by tick bites, and is endemic in some parts of the world including areas of the USA and Australia. brucellosis is contracted from infected cattle or unpasteurised milk, and is not carried by British cattle but is endemic in some countries Dental infections Chronic bacterial infections can linger in the mouth especially where there have been root-filled teeth or where teeth have been removed. Sometimes these infections are 'walled in' and can be very hard to eradicate. In a healthy person they may not be a problem, but can be a serious additional source of problems for someone who is already ill so are important to treat. parasites and protozoal infections usually caught from contaminated water or food, or via insect bites, these can lead to chronic health problems and may respond to treatment with certain antibiotics or antimicrobials. They may be suspected when illness followed foreign travel, or exposure to untreated water form rivers etc. The downside to antibiotics Dr Sarah Myhill feels that antibiotics are a "double edged sword" and said that "he had seen people who have had there M.E triggered by a violent allergy to antibiotics such as septrin". Jasmine believes that repeated courses of antibiotics when she was a child contributed to her developing severe M.E. at the age of ten. Now 21, she is extremely wary about taking them especially since she had a very adverse reaction to the antibiotic she was given to treat helicobacter pylor. She developed a nasty itchy rash on her chest and body, began wheezing and coughing, and became so weak she was unable to feed her self, within hours of taking the first tablet. 'I felt as if I was dying' she remembers, she has had antibiotics twice since then only ' under extreme pressure from the doctor' when she has seemed unable to shake off a severe bacterial infection. Her doctor takes great care to prescribes the antibiotics which she can best tolerate. She feels that she is always made worse by taking them, even though they have been effective in getting rid of particular infections. Jan has had M.E. for over ten years and believes that antibiotics always make her worse, causing an increase in all her symptoms which include muscle pain, trembling limbs, and general weakness. On several occasions this has been so severe it has caused her to collapse. She has also experienced nausea and either constipation or diarrhoea whilst taking antibiotics. she does acknowledge though that at times she has needed to take them, in order to clear a persisting infection. As she is allergic to penicillin she is usually given erythromycin. Why antibiotics can cause problems for people with M.E
• Antibiotics can effect the balance of many different strains of bacteria found in the gut. These bacteria have an important role to play in the immune system as well as in the digestion and keeping the gut wall healthy. When disrupted this can cause dysbiosis and damage to the gut wall known as leaky gut syndrome, this may even be a cause of M.E in some cases .
• Some antibiotics directly damage or suppress the immune system
• All antibiotics have side effects which can be unpredictable. Occasionally severe damage to kidneys and liver, since people with M.E have problems with their liver detoxification, they are more likely to experience toxic side effects from drugs including antibiotics.
• People have allergic reactions to antibiotics in which case a substitute may be found. Not life threatening but people with M.E are particularly prone to allergic reactions, some people with M.E. also suffer from chemical sensitivity and so are likely to react badly to any drug. Alternatives to Antibiotics Fighting infections can be tackled in many other ways than by taking a course of antibiotics, although there is no other option for certain bacterial disease of sudden onset. Many of these alternative methods approach the problem by improving the body's own defences. doctors as well as natural therapists now recognise the value of complementary approaches to improving immune function and fighting infection. These include dietary measures, relaxation and meditation, nutrition supplements, homeopathy, herbal medicines, and probiotics which restore the beneficial bacteria to the gut. examples include aloe vera , tee tree oil olive leaf extract, colloidal silver, Echinacea, and grape fruit seed extract, all of which are less likely to harm friendly gastro-intestinal bacteria. More information can be found in health food shops, books like alternatives to antibiotics by john Mckenna potentially life saving -in moderation it should not be forgotten that antibiotics can save lives in the case of acute bacterial infections. They may also be invaluable for deep- seated chronic infections. However antibiotics are generally over prescribed and it has been estimated that up to 70% of prescriptions for antibiotics are 'inappropriate and unnecessary '. Bacteria are constantly evolving and are developing resistance to existing antibiotics. It is therefore imperative to use antibiotics when they are really needed, and then to ensure that the right antibiotic and dosage is chosen for the job e.g. by taking swabs and samples before the drugs are prescribed. A preparation with a narrow mode of action is also less harmful over the long run to the body's balance of microbial inhabitants than a 'broad spectrum' antibiotic. The small minority with M.E. who've improved on antibiotics most likely either had an underlying bacterial infection or the burden of a secondary infection which was dragging them down. The latter group are not 'cured but feel somewhat better. However it's likely that most GPs will feel the risks are too great to justify a prescription of antibiotics 'on spec', however keen you may be to try them.
Reference: and further information1. breaking research reveals common bacterium chlamydia pneumoniae may
be the culprit in CFIDS, FM, and MS online news article by DrC mitchell&Dr K stratton at www.immunesupport.com/news/bacterium
2. info see www.CFSresearch.org3. books by chaitow & Mckenna 19964. see also newsletters www.immed.org5. Dr betty Dowsett tel 01708 378050 the national M.E. support center6. university of warwick micropathology ltd tel 02476 323 222
inter action issue 38 September 2001
JAZZ PHARMACEUTICALS, INC. AND SOLVAY PHARMACEUTICALS, INC. ANNOUNCE LICENSE AGREEMENT FOR LUVOX® (FLUVOXAMINE MALEATE) TABLETS AND FLUVOXAMINE MALEATE EXTENDED-RELEASE CAPSULES IN THE UNITED STATES Palo Alto, California – February 1, 2007 – Jazz Pharmaceuticals, Inc. and Solvay Pharmaceuticals, Inc. announced today a product license agreement under which Jazz Pharmaceuticals w
Text Categorization Fabrizio SebastianiIstituto di Scienza e Tecnologie dell’InformazioneConsiglio Nazionale delle RicercheVia Giuseppe Moruzzi, 156124 Pisa, ItalyE-mail: [email protected] Abstract Text categorization (also known as text classification, or topic spotting)is the task of automatically sorting a set of documents into categories froma predefined set. This task