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Meirleir treatment: avelox 400mg for overgrowth in gut

Aubry

Senior Member
Messages
189
I recently went to Kdm and I got new treatment. I have overgrowth of streptococcus and bacteroides mainly. Plus general bad gut (almost no firmicutes etc)

He proposed: Avelox 400mg, 1/day for 30 days. Hereafter: Biokult probiotic for 30 days.

I looked it a bit up and see there is 40% resistance to avelox from bacteroides :( I assume KDM knows this? I am worried cause it is a though antibiotic to take. I took ciprofloxacin before (same family) with no issues exept black tongue at the end of the course...
 

Research 1st

Severe ME, POTS & MCAS.
Messages
768
I recently went to Kdm and I got new treatment. I have overgrowth of streptococcus and bacteroides mainly. Plus general bad gut (almost no firmicutes etc)

He proposed: Avelox 400mg, 1/day for 30 days. Hereafter: Biokult probiotic for 30 days.

I looked it a bit up and see there is 40% resistance to avelox from bacteroides :( I assume KDM knows this? I am worried cause it is a though antibiotic to take. I took ciprofloxacin before (same family) with no issues exept black tongue at the end of the course...

400mg is the stronger dose to counter act precisely what you're worried about.

Also remember clinicians are allowed 'wiggle room' with the doses of medications they prescribe when it comes to treating complex hard to treat, chronic conditions. In other words, what they (specialist) find helpful in the patients they see, doctors are allowed (within reason) to formulate their own treatment regimes, especially for something like antibiotics which are notoriously hard to get right if taking for extended amounts of time.

So be mindful of that too that when looking doses up of any drug, your prescription may be lower or higher than the standard recommended amount, because ME is certainly not a standard illness, but incredibly complex and individually experienced too. This is why the medications he gives you will be individually tailored for you, and based on your abnormal test results.

If you're still worried, try and contact the clinic and raise your concerns but i'm sure they'll simply repeat what I said, that the dose he's prescribed (and the drug itself) is based on his clinical experience, in prescribing it previously so I wouldn't worry it's incorrect.

Hope that helps.
 

Aubry

Senior Member
Messages
189
Thanks :) I was worried because first search I found on google was: 40% resistance avelox on bacteroides. And my biggest overgrowth is bacteroides (30%). But I assume Meirleir knows what he gives.
 

A.B.

Senior Member
Messages
3,780

Aubry

Senior Member
Messages
189
I know...I have read the horror stories (which basically any antibiotic has somehow). I have taken Ciprofloxacin 30 days for acute prostate infection without any problems. I hope with Avelox will be the same but I suffer more (headaches, fatigue etc but prob due to die off anaerobic bacteria). I plan to take it 10 days to start. 30 days is a very long period for this kind of antibiotic so I will email KDM for alternative maybe later on.
 

Thinktank

Senior Member
Messages
1,640
Location
Europe
As stated before, avelox is a fluoroquinolone antibiotic. That's one thing i will never ever touch again in my life.
I made the unfortunate mistake to take ciprofloxacin for inflammatory bowel disease and that's when my ME really blew up. I was later diagnosed with fluoroquinolone toxicity syndrome, the damage has so far been irrepairable.
It's a minor percentage of users that will contract the syndrome but lives have been completely destroyed because of this antibiotic class, so in my opinion it should only be prescribed for life-threatening conditions.
Treating gut dysbiosis with such an antibiotic is not worth the risk.
 

Aubry

Senior Member
Messages
189
Ok. I will reconsider and ask tomorrow alternative probably. I didn't had side effects from Ciprofloxacine. I hope the 5 days I take Avelox won't give nasty side effects
 

msf

Senior Member
Messages
3,650
Since KDM believes (I believe) that the gut is the main driver of ME symptoms, it is not a minor problem. The relative risks of fluoroquinolones are hard to quantify, however, and it really is up to you whether you want to take it or not.
 

msf

Senior Member
Messages
3,650
Are you sure that KDM prescribed it for the Bacteriodes? Do you have any infections?
 

Aubry

Senior Member
Messages
189
Hmmm.. He wrote on treatment plan: IL-8 and PGE2 are way too high. Also overgrowth of anaerobic bacteria: streptococcus, bacteroides and Clostridum XVA (some strain).
samentvatting darmen.png
 

Aubry

Senior Member
Messages
189
Are you sure that KDM prescribed it for the Bacteriodes? Do you have any infections?
I think so? Since my biggest overgrowth is Bacteroides according to the stool MSA test. I hope it will kill some part of it at least or maybe he made mistake?
 

msf

Senior Member
Messages
3,650
You didn´t answer if you have any infections. If you don´t want to say, you don´t have to, but it may be for that if you have one.
 

msf

Senior Member
Messages
3,650
Anyway, why don´t you ask him what it´s for, then you can decide whether you want to take it or not?
 

Aubry

Senior Member
Messages
189
Ah sorry. Wel I probably have infections but not that I know (nothing is measured from the infection panel). I prob have still lyme and bartonella (but bartonella always tested negative in past).
 

Aubry

Senior Member
Messages
189
I also have to continue the SIBO/dysbiocide herbs (FC Cidal and Disbiocide from biotics research), together with Avelox.
 

msf

Senior Member
Messages
3,650
By the way, I´m not advocating you take anything, but if you do there are some things that may lessen some of the risks associated with fluoroquinolones, these being Magnesium and Vitamin E, and also (I think) NACL.
 

Aubry

Senior Member
Messages
189
Imipenem and meropenem resistance rates were 0-6% for B. fragilis group isolates. The rate of resistance to piperacillin-tazobactam was 2% for B. fragilis and 0% for other Bacteroides species, but 17% for B. thetaiotaomicron isolates. High resistance rates to piperacillin (72% and 69%), cefotetan (89% and 58%), and clindamycin (83% and 69%) were observed for B. thetaiotaomicron and other Bacteroides spp. The moxifloxacin (= avelox) resistance rate was 27% for other Bacteroides spp. The MIC50 and MIC90 of tigecycline were 2-4 µg/mL and 8-16 µg/mL, respectively. No isolates were resistant to chloramphenicol or metronidazole.
(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4272972/)

I will email to question the Avelox for the overgrowths I have. But I guess KDM has lot of experience with this kind of problems in general.
 

msf

Senior Member
Messages
3,650
´The resistance rates for moxifloxacin were 8%, 2%, and 27% for B. fragilis, B. thetaiotaomicron, and other Bacteroides spp., respectively.´

You might want to check which Bacteriodes species you have a problem with.
 

Aubry

Senior Member
Messages
189
Ok I didn't read well obviously. "8%, 2%, and 27%" are actually not so bad percentages :)
The MSA gut report doesn't specify the many bacteroides spp I think (red marks):

bacteroidetes phoenixrising.png
 

msf

Senior Member
Messages
3,650
You´re right, it just shows genera. I think Lipkin´s gut study showed which Bacteriodes species are generally increased in ME patients.