Clindamycin

Clindamycin, “clindy” for short, is a bacteriostatic antibiotic used by patients on the Marshall ProtocolA curative medical treatment for chronic inflammatory disease. Based on the Marshall Pathogenesis. (MP). Clindamycin comes in 75, 150 and 300mg capsules. There are no reported problems with the generic equivalent.

Prior to the MP, clindamycin has been used to treat acne, bacterial infections with anaerobic bacteria, protozoal diseases such as malaria, and can be useful against some methicillin-resistant Staphylococcus aureus (MRSA) infections.¹ Clindamycin binds to the 50S subunit of the bacterial ribosome.

Clindamycin is particularly effective at eliminating infected nerve tissue. Consequently, immunopathological reactions often involve exacerbation of Th1-related psychological symptoms. Therefore, patients with anxiety, depression, obsessive compulsive disorder, etc. should use clindamycin cautiously, as symptoms allow, and be monitored closely.

Clindamycin is typically used in three-antibiotic combinations. When used in combination with just minocyclineBacteriostatic antibiotic used by Marshall Protocol patients., it is called a “Modified Phase Two.”

Clindamycin typically comes in pills, but the liquid preparation of clindamycin is acceptable. The pediatric form is called Cleocin and comes in flavored granules for oral solution at 75mg per 5 ml. Patients' pharmacists can instruct them on how to mix it and how long the solution would be good after it has been mixed.

Some patients have complained about the taste of liquid clindamycin.

The maximum recommended dose of clindamycin is 150mg. The maximum recommended frequency is every other day. As with other MP antibiotics, patients are advised to increase their dose of clindamycin incrementally, which insures safety and that a range of pathogens are being targeted.

The standard amount to increase clindamycin is 37.5mg, which is 1/4 of a 150mg pill or 1/8 of a 300mg pill.

Patients concerned about intolerable immunopathologyAn unbearable or unsafe severity of bacterial die-off reaction. can increment their dose by 25mg, which is 1/6 of a 150mg pill or 1/12 of a 300mg pill.

Clindamycin should be taken at the same time as any other every-other-day antibiotics.

A compounding pharmacy will make up capsules in whatever size clindamycin a patient needs, including 37.5mg, which equals 1/4 a clindamycin pill, the typical starting dose for Phase 3.

There are patients that find smaller doses are sufficient for stimulating adequate immune response. Some have had clindamycin compounded at 5, 10, or 20 mg dose levels.

Patients who wish to maximize their insurance benefit should ask their doctors to prescribe the highest number of clindamycin capsules they feel comfortable with. Because clindamycin is often used in much higher amounts for acute infections, this dosing schedule is typically not questioned by insurance companies. However, there are usually no refills ordered with this type of prescription.

Two examples of these prescriptions are “ninety 150mg capsules” and “sixty 300mg capsules.”

As specified in greater detail in the Protocol Guidelines, patients on the Marshall Protocol begin by taking regular doses of olmesartan (Benicar)Medication taken regularly by patients on the Marshall Protocol for its ability to activate the Vitamin D Receptor. and then, later on, increasing doses of minocycline. When ready to experience additional immunopathologyA temporary increase in disease symptoms experienced by Marshall Protocol patients that results from the release of cytokines and endotoxins as disease-causing bacteria are killed., patients begin to take a second antibiotic.

Typically, that second antibiotic is azithromycin (Zithromax)Bacteriostatic antibiotic used by Marshall Protocol patients. Has relatively long half-life.. Under certain circumstances, patients and their physicians may wish to use clindamycin.

• When to use ZithromaxBacteriostatic antibiotic used by Marshall Protocol patients. Has relatively long half-life. as a second antibiotic (Phase Two) – Patients with significant psychological symptoms such as depression, anxiety, intrusive thoughts, or obsessive-compulsive behavior should use azithromycinBacteriostatic antibiotic used by Marshall Protocol patients. Has relatively long half-life., because clindamycin often exacerbates these symptoms to intolerable levels. For these patients, clindamycin is usually tolerated better at later stages of the treatment.
• When to use clindamycin as a second antibiotic (Modified Phase Two) – Clindamycin doesn't linger in the tissues like Zithromax, so it is easier to control the immune system reactions. Clindamycin is helpful for patients who are very sick and may not be able to tolerate the relatively prolonged effect of Zithromax.

Patients who are still experiencing significant immunopathology from 100mg of minocycline alone are not yet ready to add a second antibiotic because the two antibiotic combination, especially when Zithromax is used, is much stronger than minocycline alone.

A special consideration for patients with high levels of 25-DThe vitamin D metabolite widely (and erroneously) considered best indicator of vitamin D "deficiency." Inactivates the Vitamin D Nuclear Receptor. Produced by hydroxylation of vitamin D3 in the liver. – Patients should not begin azithromycin until their serum level of 25-D drops below 12ng/ml, at which point, they may carefully introduce it. The reason for this caution is because a high level of 25-D suggests a relatively inactive immune response. By taking shorter-acting antibiotics such as clindamycin (as opposed to azithromycin), patients may minimize the length of time they experience a profound response to their antibiotics. An exception may be made for patients who are healthy enough to handle a substantial increase in immunopathology. In this case, physicians may want to wait until a patient's 25-D drops below 20ng/ml.

In later stages of the treatments, demeclocyclineBacteriostatic antibiotic used by patients on the Marshall Protocol. may be combined with other MP antibiotics in the following fashion:

• BCD – Bactrim DSSulfa antibiotic used by patients on the Marshall Protocol. Combination of sulfamethoxazole and trimethoprim. Works by blocking bacterial folic acid synthesis. + clindamycin + demeclocycline
• BCM – Bactrim DS + clindamycin + minocycline
• CDM – clindamycin + demeclocycline + minocycline
• CDZ – clindamycin + demeclocycline + Zithromax
• CMZ – clindamycin + minocycline + Zithromax