Hi Dale

Sorry I haven't been able to get back to you, but I have had a really busy
week, taking care of my brothers grandchildren. Very hectic, I promise I
will be in touch this week end. I hope you are doing better. God Bless
Diane,
----- Original Message -----
From: "Dale" <dale@...>
To: <paratuberculosis@yahoogroups.com>
Sent: Thursday, February 07, 2008 12:23 AM
Subject: [paratuberculosis] Two-year combination antibiotic therapy...


> They concluded that the antibiotics didn't have a sustained benefit in
> treating Crohn's then went on to say: "Short-term improvement was seen
> when this combination was added to corticosteroids, most likely because of
> nonspecific antibacterial effects."
>
> Corticosteroids suppress the imune system and reduce inflammation? So I
> take it while they were trying to see if antibiotics would kill the
> bacteria, they were simultaneously suppressing the immune system
> inhibiting it from killing the bacteria.
>
> Maybe they were using some kind of corticosteroids that don't ... oh,
> nevermind.
>
> -- Dale
> <http://DaleRoose.com/>
>
> Gastroenterology. 2007 Jun;132(7):2313-9. Epub 2007 Mar 21.
>
> Comment in:
> Gastroenterology. 2007 Jun;132(7):2594-8.
> Gastroenterology. 2007 Nov;133(5):1742-3; author reply 1745-6.
> Gastroenterology. 2007 Nov;133(5):1742; author reply 1745-6.
> Gastroenterology. 2007 Nov;133(5):1743-4; author reply 1745-6.
> Gastroenterology. 2007 Nov;133(5):1744-5; author reply 1745-6.
>
> Two-year combination antibiotic therapy with clarithromycin, rifabutin,
> and clofazimine for Crohn's disease.
>
> Selby W, Pavli P, Crotty B, Florin T, Radford-Smith G, Gibson P, Mitchell
> B, Connell W, Read R, Merrett M, Ee H, Hetzel D; Antibiotics in Crohn's
> Disease Study Group.
>
> Royal Prince Alfred Hospital, Sydney, Australia.
> warwicks@...
>
> BACKGROUND & AIMS: Mycobacterium avium subspecies paratuberculosis has
> been proposed as a cause of Crohn's disease. We report a prospective,
> parallel, placebo-controlled, double-blind, randomized trial of 2 years of
> clarithromycin, rifabutin, and clofazimine in active Crohn's disease, with
> a further year of follow-up. METHODS: Two hundred thirteen patients were
> randomized to clarithromycin 750 mg/day, rifabutin 450 mg/day, clofazimine
> 50 mg/day or placebo, in addition to a 16-week tapering course of
> prednisolone. Those in remission (Crohn's Disease Activity Index <or=150)
> at week 16 continued their study medications in the maintenance phase of
> the trial. Primary end points were the proportion of patients experiencing
> at least 1 relapse at 12, 24, and 36 months. RESULTS: At week 16, there
> were significantly more subjects in remission in the antibiotic arm (66%)
> than the placebo arm (50%; P=.02). Of 122 subjects entering the
> maintenance phase, 39% taking antibiotics experienced at least 1 relapse
> between weeks 16 and 52, compared with 56% taking placebo (P=.054). At
> week 104, the figures were 26% and 43%, respectively (P=.14). During the
> following year, 59% of the antibiotic group and 50% of the placebo group
> relapsed (P=.54). CONCLUSIONS: Using combination antibiotic therapy with
> clarithromycin, rifabutin, and clofazimine for up to 2 years, we did not
> find evidence of a sustained benefit. This finding does not support a
> significant role for Mycobacterium avium subspecies paratuberculosis in
> the pathogenesis of Crohn's disease in the majority of patients.
> Short-term improvement was seen when this combination was added to
> corticosteroids, most likely because of nonspecific antibacterial effects.
>
>
>
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