Dr. E. Murakami Centre for Lyme

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Why Long Term Therapy?

 

There exists much controversy over the protocol of antibiotic treatment for Lyme sufferers. The last protocol developed following the IDSA Guidelines out of the US suggested that 30 day antibiotic treatments  were sufficient to irradicate any presence of  Borrelia burgdorferi in a patient's body. Canada follows these guidelines in the development of our treatment protocol.

Many Lyme Literate Doctors (LLMD's) have known through personal experience and close communications and treatment of their patients, that this, infact, is not the case.

In May 2008, the Attorney General of Connecticut, Mr. Blumenthal,  found the IDSA Guidelines to be seriously flawed; being formed untruthfully by a board of heavily biased and swayed members (by US Insurance Companies). This review of the Guidelines has lead to a disbanding of the old Board, and an election of new, unbiased individuals to review and re-develop the standards for Lyme treatment. We wait with baited breath for the results in favour of what most LLMD's know as the truth. You can view Mr. Blumenthal's report in full on our site at IDSA Guidelines Flawed.

This further supports Dr. Murakami's own personal findings regarding the long term treatment of Lyme. Information taken from patient charts were developed to further prove the effects of long-term antibiotic treatments. 

In order to understand why long term treatment is necessary, one must first understand the physiology of the Borrelia burgdorferi bacterium. Dr. Joseph Burrascano has put together an excellent journal addressing this completely. The study of Syphilis would also further the knowledge required to understand Lyme. This comparison has been noted by Dr. Murakami during his tenure as a physician and is key to his indepth understanding of this bacterium.

The "cystic" form of the Borrelia burgdorferi bacterium is where the problem in treatment lies. This formation that the bacterium evolves into offers pronounced "protection" from any assail of treatment and environmental conditions. Many studies have been done to verify this. A noteable study on the motility of the spirochaete and the cystic form was noted and recorded back as far as 1985!

This then brings in a new group of skeptics who believe there is no chronic lyme. Dr. Burrascano's research journal quotes:

"Chronic Lyme is an altogether different illness than earlier types, mainly because of the inhibitory effect on the immune system (Bb has been demonstrated in vitro to both inhibit and kill B- and T-cells, and will decrease the count of the CD-57 subset of the natural killer cells). As a result, not only is the infection with Bb perpetuated, but the entire issue of co-infections arises. Ticks may contain and transmit to the host amultitude of potential pathogens. The clinical presentation of Lyme therefore reflects which pathogens are present and in what proportion. Apparently, in early infections, before extensive damage to the immune system has occurred, if the germ load of the co-infectors is low, and the Lyme is treated, many of the other tick-transmitted microbes can be contained and eliminated by the immune system. However, in the chronic patient, invariably the illness reflects a mixed infection, the individual components of which are now active enough that they too must be treated. In addition, many latent infections which may have predated the tick bite, for example herpes viruses, can reactivate, thus adding to the illness.

An unfortunate corollary is that serologic tests can become less sensitive as the infections progress, obviously because of the decreased immune response upon which these tests are based. Not surprisingly the seronegative patient will convert to seropositive 36% of the time after antibiotic treatment is begun and a recovery is underway.

The severity of the clinical illness is directly proportional to the spirochete load, the duration of infection, and the presence of co-infections. These factors also are proportional to the intensity and duration of treatment needed for recovery. More severe illness also results from other causes of weakened defenses, such as from severe stress, immuno-suppressant medications, and severe intercurrent illnesses. This is why steroids and other immunosuppressive medications are contraindicated in Lyme."

  

The full journal on his suggested treatments exists on this site for further reference.

In order for treatment to be efficacious, any underlying co-infections must be treated first, particularily the involvement of Babesiosis or Bartonella. It has been discovered that the parasitic tendencies of these co-infections inhibit the irradication of the Borrelia burgdorferi bacterium, also it is not understood how exactly. This is where effective blood tests, coupled with effective clinical diagnosis MUST be made by physicians who are privy to proper diagnosis of Lyme.

Dr. Donta, MD and Director of Infectious Disease and BioMolecular Medicine at Boston University, has provided an excellent source of wisdom and research in an article covering all aspects of Lyme for the treating physician.

Education is key to successful treatment of Lyme in our world today. The medical community needs to be properly informed and needs to stand united on the frontlines of this epidemic known as Lyme