Antibiotics under special circumstances

Related article: Other treatments

For reasons ranging from prophylaxis to acute infections, Marshall ProtocolA curative medical treatment for chronic inflammatory disease. Based on the Marshall Pathogenesis. (MP) are sometimes advised to take an antibiotic. If possible, patients ought to verify with their doctor:

  • they have a bacterial illness; this can be done via a culture
  • (if the antibiotic is prescribed as a prophylaxis) that the MP antibiotics wouldn't suffice

If a patient must take an antibiotic, Ceftin, Biaxin or fluoroquinolones are recommended, as they minimize the possibility of unstable 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.. Use of these does not preclude an MP patient from continuing with olmesartanMedication taken regularly by patients on the Marshall Protocol for its ability to activate the Vitamin D Receptor. Also known by the trade name Benicar. .

Patients on the MP should not take nimesulide (Aulin / Mesulid / Nimed). It could possibly cause internal bleeding.

Verify the diagnosis

If one's doctor has ordered a short course of a non-MP antibiotic because of a suspected infection, first verify that it is an acute bacterial – not viral – infection and that another antibiotic is necessary.

Immunopathologic symptoms may appear very similar to symptoms of infection, especially in the area of ears, throat and sinuses. In most cases, there is time to do a culture to verify the diagnosis and select the correct antibiotic.

Urgent or emergency situations

Related article: Hospitals and emergencies

In the case of an obvious acute bacterial infection or in an emergency situation, patients should:

  • follow their doctors orders to start the needed antibiotic right away
  • discontinue any MP antibiotics
  • inform their doctor the last time olmesartan was taken, that it may potentiate the antibiotic, and cause an immune system reaction
  • if a patient has been taking azithromycin (Zithromax), inform the doctor that it may be synergistic with the new antibiotic for a few weeks as it lingers in your tissues

Be alert for a potential immune system reaction and treat symptoms as they arise.

Prophylactic antibiotics

Related articles: Working with a dentist, Surgery

Dentists and surgeons sometimes order a brief course of an antibiotic before a procedure. Verify that this is essential. Ask your doctor if the current MP antibiotics you are taking would suffice to prevent infection.

Generally speaking, patients should strive to avoid the beta-lactam antibiotics such as amoxicillin, which give unpredictable, and sometimes severe, reactions once a patient's immune system is functioning properly after having been on the MP.

Danger of taking additional MP antibiotics

Sometimes a physician will prescribe a Marshall Protocol (MP) antibiotic such as clindamycin, or any of the sulfanomides such as Bactrim DS, or azithromycin (Zithromax) as a prophylactic measure without understanding how taking more than the MP-recommended dose can affect immunopathology.

Of these medications, taking high doses of azithromycin would be particularly problematic for the following reasons:

  • relative long half-life
  • does not have a dose-dependent immunosuppressive effect
azithromycin has been removed from the few MP accepted ABx for the above and for other reasons

In order to convince a doctor not to prescribe them additional MP antibiotics, some patients have simply said they are allergic to these antibiotics. Although patients technically are not allergic to MP antibiotics, this may be the easiest explanation for a doctor to understand and accept.

Antibiotics for short term use in acute infection

Ceftin (Cefuroxime, Zinacef, Supacef , Zamur ) may offer the best option for patients who need a non-MP antibiotic.

Biaxin (Clarithromycin) has been reported with similar good results, but may not be suitable for a patient with any heart condition.

Biaxin and Ceftin are actually preferred over fluoroquinolones now that the tendon damage due to fluoroquinolones is becoming better documented.

Main article: Fluoroquinolones

While there are several reasons why the class of antibiotics known as the fluoroquinolones are not recommended as a part of the Marshall Protocol, for short-term use, the drugs may offer an option for patients who need a non-MP antibiotic.

Because fluoroquinolones do not target intracellular bacteria as do the MP antibiotics, they do not work synergistically with the MP antibiotics.1) This allows MP patients to continue with olmesartan (Benicar)Medication taken regularly by patients on the Marshall Protocol for its ability to activate the Vitamin D Receptor. and the MP antibiotics. It also gives patients the option to use olmesartan and/or minocycline to control their immunopathological reactionA temporary increase in disease symptoms experiences by Marshall Protocol patients that results from the release of cytokines and endotoxins as disease-causing bacteria are killed..

One example of what appears to be a relatively well-tolerated cephalosporin is claforan (Cefotaxime).

Letter composed by Grateful Survivor for her doctors

If antibiotic therapy is necessary to treat an acute infection, I strongly request that you NOT prescribe any fluoroquinolone for me, due to concerns over possible adverse effects to tendons. I am already predisposed to tendinitis. Please see the attached Notice for Emergency Personnel from the Marshall Protocol, a supervised study protocol of which I am a study subject. The following are noted as ok or usually ok in the Marshall Protocol document:

  • Cephalosporins especially Claforan
  • Biaxin

In addition to the antibiotic recommendations in the Marshall Protocol document, the following antibiotics have been taken without adverse incident by at least some study participants:

  • Keflex
  • Bactrim
  • Clarithromycin
  • Nitrofurantoin
  • Amoxicillin
  • Dicloxacillin
  • Vancomycin only in case of extreme need

Bactrim, however, perhaps is better avoided by anyone who has a tendency to high potassium MedPage which is not controlled by sodium bicarbonate (see baking soda)

Managing immunopathology

Main article: Managing immunopathology

Patients who take a non-MP antibiotic and see their symptoms increase should consider their reaction immmunopathology and should consider using the same strategies they would typically use to decrease any intolerable reactions – unless, of course, the patient is no longer on olmesartan (Benicar). Patients should consult with their physician to determine which strategies are most effective.

Resuming the MP after taking a non-MP antibiotic

Patients who have taken non-MP antibiotics for a period can resume olmesartan 48 hours after the last dose of the non-MP antibiotic unless they have been taking azithromycin, in which case they must wait two weeks before resuming olmesartan.

Patients should wait 24-48 hours before resuming minocycline in case there are any intolerable adjustment symptoms due to the reintroduction of the olmesartan.

Patients who took non-MP antibiotics for only a day or two may resume minocycline at the previous dose. For those whose non-MP antibiotic course was longer, restart minocycline at a lower dose to avoid a strong immue system reaction.

===== Notes and comments =====

Sallie Q 11.17.2015 edit on preferred ABx for acute infection

Sallie Q 11.14.2015 added Zith warning

I haven't had time to wrk on this. Biaxin and Ceftin are actually preferred over flouroquinolones now that the tendon damage due to flouroquinolones is becoming better documented. Also, I don't like the term “MP antibiotics” but I don't have time to work on this any more until after the FDA presentation, ===== References =====

Rolain J, Stuhl L, Maurin M, Raoult D. Evaluation of antibiotic susceptibilities of three rickettsial species including Rickettsia felis by a quantitative PCR DNA assay. Antimicrob Agents Chemother. 2002 Sep;46(9):2747-51. doi: 10.1128/AAC.46.9.2747-2751.2002.
[PMID: 12183224] [PMCID: 127393] [DOI: 10.1128/AAC.46.9.2747-2751.2002]
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