PDF(Pubmed)
Abstract：
Three patients with relapsing and remitting borreliosis, babesiosis, and bartonellosis, despite extended anti-infective therapy, were prescribed double-dose dapsone combination therapy (DDDCT) for 8 weeks, followed by one or several two-week courses of pulsed high-dose dapsone combination therapy (HDDCT). We discuss these patients\' cases to illustrate three important variables required for long-term remission. First, diagnosing and treating active co-infections, including Babesia and Bartonella were important. Babesia required rotations of multiple anti-malarial drug combinations and herbal therapies, and Bartonella required one or several 6-day HDDCT pulses to achieve clinical remission. Second, all prior oral, intramuscular (IM), and/or intravenous (IV) antibiotics used for chronic Lyme disease (CLD)/post-treatment Lyme disease syndrome (PTLDS), irrespective of the length of administration, were inferior in efficacy to short-term pulsed biofilm/persister drug combination therapy i.e., dapsone, rifampin, methylene blue, and pyrazinamide, which improved resistant fatigue, pain, headaches, insomnia, and neuropsychiatric symptoms. Lastly, addressing multiple factors on the 16-point multiple systemic infectious disease syndrome (MSIDS) model was important in achieving remission. In conclusion, DDDCT with one or several 6-7-day pulses of HDDCT, while addressing abnormalities on the 16-point MSIDS map, could represent a novel effective clinical and anti-infective strategy in CLD/PTLDS and associated co-infections including Bartonella.
摘要：
三例复发和缓解的伯利松病患者，babesiosis,和巴顿病，尽管延长了抗感染治疗，服用双倍剂量氨苯砜联合治疗（DDDCT）8周，随后是一个或几个为期两周的脉冲大剂量氨苯砜联合治疗（HDDCT）疗程。我们讨论这些患者的病例来说明长期缓解所需的三个重要变量。首先,诊断和治疗活动性共感染，包括Babesia和Bartonella都很重要.巴贝虫需要多种抗疟疾药物组合和草药治疗的轮换，和巴尔通体需要一个或几个6天的HDDCT脉冲来实现临床缓解。第二,所有先前的口头，肌内（IM），和/或用于慢性莱姆病（CLD）/治疗后莱姆病综合征（PTLDS）的静脉（IV）抗生素，不管给药时间长短，疗效不如短期脉冲生物膜/持久性药物联合治疗，即氨苯砜,利福平,亚甲蓝,还有吡嗪酰胺,提高了抗疲劳能力，疼痛,头痛,失眠,神经精神症状.最后,在16点多重全身性传染病综合征(MSIDS)模型中解决多个因素对于实现缓解非常重要.总之,DDDCT具有一个或几个6-7天的HDDCT脉冲，在解决16点MSIDS地图上的异常时，在CLD/PTLDS和包括巴尔通体在内的相关共感染中，可以代表一种新的有效的临床和抗感染策略。
