The antibiotics used for anti-map make Ecoli more resistant? never heard that before.I've been tested twice for MAP. One was in a veterinary lab with lots of experience testing ruminants with johne's disease. It's a PCR test of whole blood that takes a couple of days, and culture tests that takes about 2 years, every 6 months the culture is tested for MAP. The second test was a general test of blood for presence of mycobateria, including map, less specific than the first, but capable of detecting MAP.
All of those tests were negative, yet I have classical crohn's disease of the ileum, drank lots of milk as a child, I'm the perfect candidate for the presence of MAP. Yet I don't have any according to my results.
This is very common, people with crohn's disease testing negative for MAP, neither in blood or tissue. Some people will argue it's in deeper tissue, that they should check fistulas, etc.
There's just too many studies that can't find MAP, but can detect invasive E coli for example, that it's unlikely that crohn's disease is being caused by MAP in everyone.
I really like the idea that MAP causes crohn's disease, because it makes a lot of sense, it would explain the distribution of the disease in western countries exposed to dairy, it would explain the onset of the disease that matches the onset of johne's disease, etc.
But until they can find it consistently, you can't treat people for it currently, because the antibiotics used for it need to be used for years, because MAP is a slow dividing bacteria, the antibiotics don't treat the invasive E coli that is found much more consistently than MAP but it causes the E Coli to be even more resistant.
There's a single study from Borody where he argues anti-MAP antibiotics work to treat crohn's disease. But there's a number of issues with it I feel, none of the patients were tested for the presence of MAP at any point in the study afaik, because 3 antibiotics were used it's a very broad-spectrum treatment that's not specific for MAP, one of those antibiotics used, Clofazimine, has an anti-inflammatory effect that's unrelated to it's anti-bacterial properties.
Another study that used the same antibiotics didn't see any positive results.
Also, one of the most effective antibiotics used for crohn's disease is still simply cipro, and that's not effective against MAP, but it extremely effective against invasive E Coli. How does that fit in with the theory that MAP causes crohn's disease.
Yes, macrolides like clarithromycin used against MAP will create resistance against invasive E Coli found in crohn's disease patients.The antibiotics used for anti-map make Ecoli more resistant? never heard that before.
Well, that's a pretty small sample size. But you seem very knowledgable with immunology, and I consider myself pretty informed.Yes, macrolides like clarithromycin used against MAP will create resistance against invasive E Coli found in crohn's disease patients.
I posted an article about this a while ago.
http://www.crohnsforum.com/showthread.php?t=39306
"AIEC strains from ICD (6/8 patients) versus 2/6 NI (2/5 patients) showed resistance to the macrophage-penetrating antimicrobials ciprofloxacin, clarithromycin, rifampicin, tetracycline, and trimethoprim/sulfamethoxazole."
One of the possible complications with using these drugs to treat MAP without knowing if the host actually has any MAP, is that you're creating resistance for drugs that are more specific for E Coli like cirpo, which is quite effective against AIEC.
It is used sparingly to treat crohn's disease and infections related to crohn's disease.Why is Ciproflaxin not used more often for Crohns patients? I've had this disease for almost 20 years and I don't think I've ever heard a GI mention it.
What is your opinion on the the Redhill Biopharm triple anti-biotic therapy? Side effects, potential bad reactions, etc. Do you consider it safe? Do you think it is something that could negatively impact somebody in the future?It is used sparingly to treat crohn's disease and infections related to crohn's disease.
But...
-Cipro is a heavy drug, it's not something you want people to stay on, it can cause severe nerve damage like all fluoroquinolones. I have used cipro before and it gave me incredible headaches and had to stop after 2 weeks.
-Like the article above mentions, AIEC builds resistance against cipro quickly
-AIEC is capable of remaining dorment deep in tissue and macrophages and can recolonise after antibiotic use
-Cipro is a broad spectrum antibiotic that will negatively affect your gut flora, it is a disturbed gut flora that allows AIEC to colonize the gut of mice http://www.ncbi.nlm.nih.gov/pubmed/22344932
There's only 2 studies that used those 3 antibiotics afaik. I don't know how long Borody keeps patients on those, but I'm assuming years, because MAP is a slowly dividing bacteria. (which is why culture takes months, my culture took 2 years with 6 month intervals).What is your opinion on the the Redhill Biopharm triple anti-biotic therapy? Side effects, potential bad reactions, etc. Do you consider it safe? Do you think it is something that could negatively impact somebody in the future?
There's been 2 tests with those 3 antibiotics, and the conclusion of one where the regime failed, was that in theory it could, which is why their conclusion included caution.Do you think it is something that could negatively impact somebody in the future?
I have not done any tests for MAP, and I am unsure if they plan on testing for it before treatment. I think she said they may plan on testing me DURING the treatment. Which doesn't make much sense. But, I am having second thoughts. Tomorrow is just a screening to see if I'd even qualify.There's only 2 studies that used those 3 antibiotics afaik. I don't know how long Borody keeps patients on those, but I'm assuming years, because MAP is a slowly dividing bacteria. (which is why culture takes months, my culture took 2 years with 6 month intervals).
If I was in front of that decisions, I would at least want someone to show me I actually harbour that bacteria. The IS900 PCR test for MAP, would have to be positive before I could even contemplate thinking about going on a long term drug regime like that. I did that test, it was negative, I did 2 blood tests and another culture test and all came out negative.
Are you tested positive for MAP or do they plan to test for the presence of MAP before treatment?