Treatment protocols of Chlamydophilia Pneumoniae - cpnhelp.org

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These documents are aimed towards professionals for guidance on the treatment of Chlamydophilia Pneumoniae bacteria. Treatment protocols by Dr Stratton of Vanderbilt University, Dr Sriram of Vanderbilt University, as well as Dr. Wheldon, a UK microbiologist.

Below are a number of different protocols as recommended by Drs Stratton, Sriram of Vanderbilt University and Dr Wheldon UK consultant microbiologist. With all the protocols it is important to take note of your reactions and tailor the treatment to suit your condition. It is recommended that before you start you should ask your doctor for a liver enzyme test and a standard blood test to provide a bench mark for future comparison.

What is a Combined Antibiotic Protocol?

A Combined Antibiotic Protocol (CAP) is a treatment strategy often used in the management of certain chronic infections, particularly those caused by intracellular pathogens like Chlamydia pneumoniae (Cpn). This protocol involves the use of multiple antibiotics concurrently, aiming to enhance the efficacy of treatment by targeting different aspects of the infection and reducing the likelihood of antibiotic resistance.

Typically, CAPs may include a combination of antibiotics that work synergistically to penetrate cells, where some pathogens may reside and evade treatment. The selection of antibiotics can vary based on the specific infection and the patient’s individual circumstances, including their health status and any prior treatment history.

Monitoring is essential while on a CAP, as patients may experience varying reactions to the medications, and adjustments may be needed to optimize treatment outcomes. It's often recommended that this protocol be supervised by a healthcare professional familiar with the complexities of treating chronic infections.

 

Treatment Protocols

Wheldon Protocol

  • Doxycycline 100 mg, x2 a day
  • Azithromycin 250 mg, Mon, Wed, Fri (Alternatively Roxithromycin 150 mg, x2 a day)
  • Every three weeks for five days: Metronidazole 400 mg, x3 a day (Alternatively Tinidazole 500 mg, x2 a day)

Metronidazole also called Flagyl Pulse. When the first two antibiotics are well tolerated, probably after three months, start pulsing the third. For one day, every three to four weeks initially. Increase the number of days per pulse gradually to five days. Dosage varies from country to country.

When the protocol is well tolerated Doxycycline and Azithromycin (or Roxithromycin) are taken continuously as outlined above. They prevent Cpn from replicating as well as killing it slowly (these antibiotics are called bacteriostatic antibiotics). After three or four months of these two antibiotics you can start pulsing the third antibiotic.

Definition of a pulse. Think of a cycle of treatment as a period of time. How long that period is depends on how well you are coping with the Combined Antibiotic Protocol (CAP), usually this cycle is three or four weeks long. Once during this period of time you take Metronidazole (or Tinidazole) for a period of up to 5 days at the full dose, this is what we call a pulse. In the beginning of your treatment the pulse may be only one day long, as you tolerate the CAP you can increase the number of days you take the metronidazole. Well into the treatment you may want to increase the number of days you take Metronidazole (or Tinidazole) beyond the 5 days recommended.

The reason behind a pulse is that Metronidazole or Tinidazole are the killer antibiotics (called bactericides) and when Cpn dies it releases toxins into your blood that your body has to process. This pulsing allows your body to recover and makes the treatment more bearable.

 

Sriram Protocol

  • Rifampin 300mg, x2 a day
  • Azithromycin 250 mg, Mon, Wed, Fri
  • After 30 days: Metronidazole 400 or 500 mg, x3 a day (Take it 15 days on and 15 days off for the duration of the treatment)
  • After 8 weeks: Sodium or Calcium Pyruvate (up to) 4g

Rifampin is a very effective killer of RBs and therefore it may take a while to feel comfortable taking it. It may take longer than the two weeks suggested in the chart. It is also worth noting that Rifampin can affect the efficacy of other drugs you may be taking such as Thyroxine for example. It may also cause your liver enzymes to become elevated and for that reason you should be closely monitored by a doctor. In this protocol Metronidazole pulses are 15 days long, this may well be very difficult to sustain and in that case patients have been advised to reduce the pulse to 7 days in 21.

 

Stratton Protocol

  • Clarithromycin 500 mg, x2 a day (Alternatively Roxithromycin 150 mg, x2 a day OR Azithromycin 250 mg, MWF)
  • Doxycycline 100 mg, x2 a day
  • Pyruvate 6g
  • N-acetylcysteine (NAC) 600 mg, x1 a day
  • After 30 days: Metronidazole 400 or 500 mg, x3 a day (Take it 7 days)

Dr Stratton recommends that you start by taking 600 mg of N-Acetyl Cysteine (NAC) a day; this is a supplement which you can buy over the counter. Taking NAC may reveal the extent of the Cpn load. You may get the flu like symptoms described here. If the reactions are severe you may need to take 5mg of prednisone a day for the first few weeks of therapy. If there are no reactions increase the dose of NAC to 1200mg a day and continue to take this for the duration of the treatment and beyond.

 

What is Chlamydia pneumoniae

Chlamydia pneumoniae (or Chlamydophilia Pneumoniae) is a type of bacteria that primarily causes respiratory infections. It can lead to conditions like pneumonia, bronchitis, and sinusitis. This bacterium is transmitted from person to person, often through respiratory droplets when an infected person coughs or sneezes. Infections caused by Chlamydia pneumoniae can be mild and may not always present noticeable symptoms. However, in some cases, it is believed to play a major role in developing Multiple sclerosis, Chronic fatigue, Cardiac disease, Interstitial cystitis, Prostatitis, Crohn's disease, Inflammatory bowel disease, Alzheimer's disease, Asthma, Arthritis, Fibromyalgia, Chronic refractory sinusitis, Macular Degeneration, and others. Diagnosis typically involves clinical evaluation and may include tests such as blood tests or cultures. Treatment usually involves antibiotics, which are effective against this type of bacteria.

 

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