Zithromax and its immune modulating effect

[sptcmom]

DS started on Zithromax (switched abx)a month ago and has since then gone thru THREE sinus infections. A cold that went south with yellow-green nasal discharge- the hallmark of viral leading to superimposed bacterial infection. He's ramped up during those times as expected and have been managing on herbs and homeopathic. Did some research on Zith and found the following very interesting article. I will ask my LLMD about this. If Zith makes it harder to clear nasal strep, how the heck do I get around the PANDAS aspect f this Pandas-lyme equation I have going on with DS.I understand they're talking about streppneumo serotypes but nasal strep is nasal strep.

 

Here it is

The Journal of Infectious Diseases 2004;190:17621766

© 2004 by the Infectious Diseases Society of America. All rights reserved.

 

0022-1899/2004/19010-0007$15.00

DOI: 10.1086/425038

 

BRIEF REPORT

 

Azithromycin Modulates Murine Immune Responses to Pneumococcal Conjugate Vaccine and Inhibits Nasal Clearance of Bacteria

 

Aracelis D. Fernandez,1,2 Monica K. Elmore,1,a and Dennis W. Metzger1

1Center for Immunology and Microbial Disease and 2Department of Pediatrics, Albany Medical College, Albany, New York

 

Abstract

 

Macrolide antibiotics, including azithromycin, have been implicated in the modulation of host immune responses, independently of their antimicrobial properties. The present work was designed to study the effect that azithromycin has on protective humoral immune responses induced by a 7-valent, polysaccharide, pneumococcal conjugate vaccine (PCV7). By use of a murine vaccination/challenge model, it was found that inoculation with azithromycin led to significantly lower primary antibody responses, decreased recall proliferative responses, and, in nasal cavities, impaired clearance of Streptococcus pneumoniae serotype 14 from the nasal cavities. The results demonstrate that azithromycin can be inhibitory with regard to protective immune responsiveness.

 

Full version:

http://www.journals.uchicago.edu/doi/fu ... 086/425038

Edited January 2, 2011 by sptcmom

[RNmom]

I could only read the abstract so this response is limited. I do know that one PANDAS doc we consulted with believed that strep pneumonia is the MAJOR culprit in PANDAS. He treats PANDAS with an aggressive course of Bicillin shots to specifically address the strep pneumonia organism which can "hide out" in the nasal and sinus cavities.

 

Many parents I talk with, who have their PANDAS kids on Zithromax, will also combine it with Augmentin XR or Bicillin shots weekly or bi-weekly. They came about this combination through trial and error. My first reaction to your post was, "Maybe that is why so many of us have had "breakthrough strep" and increased PANDAS symptoms when our kids have been on Zith alone.

 

Now - sorry to make this more complicated but - many of the same parents have found that they get "breakthrough strep" etc. on Augmentin alone. I think the take home message might be that a combination of antibiotics can work well for many kids with PANDAS.

 

Also, in many of these cases the child has PANDAS and Lyme - so Zithromax was necessary as part of the Lyme protocol (as it seems to be the case with your child). That would be our case as well. We have our son on 3,000 mg Augmentin XR daily (he is 165 lbs) in addition to 600mg Zithromax daily, Mepron daily x 21 days alternating with Flagyl daily x 7 days, and 400 mg Doxycycline daily. Every time we try and decrease the Augmentin XR (thinking, "surely he is on enough antibiotic coverage") he has increased OCD!

 

It looks like an interesting article - I wish I could access all of it. Thank you for the post.

 

P.S. Check out Buster's excellent explanation of immune modulation (specifically using Zithromax as an example) over on the PANDAS forum under "What does immune modulating effect mean?" I read it just after I posted this.

Edited January 2, 2011 by RNmom