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  Information on  Antibiotics in Neurology

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Antibiotic in autoimmune disease

Helicobacter Pylori  is a communicable bacteria that drills its way through the stomach mucosa and attaches itself to the inside of the epithelia or stomach lining. Our body has a ingenious way of keeping the immune system from attacking the food we eat. It isolates the stomach’s content so the immune system can't see it. The body does this by coating the stomach with a jelly-like substance and preventing antibodies from entering through the stomach lining. The food is then digested and enters the small intestine. If nature didn't separate the food our immune systems would see it as a foreign intruder and attack it.

People suffering from H. Pylori have been cured of ITP if they took antibiotics to eradicate H. Pylori. Here is a recently published study.
Platelets. 2005 Mar;16(2):117-9.
High prevalence of sustained remission of idiopathic thrombocytopenic purpura after Helicobacter pylori eradication: a long-term follow-up study.

Veneri D, Department of Medicine, Haematology, University of Verona, Verona, Italy.

We studied the effect of Helicobacter pylori (H. pylori) eradication in 43 consecutive H. pylori-infected patients with idiopathic thrombocytopenic purpura. H. pylori was eradicated with antibiotics in 41 of them (95.3%). The difference between the mean platelet count before and after therapy was statistically significant (54.3 x 10(9)/l vs. 119.1 x 10(9)/l; P < 0.001). A sustained remission was observed in 20 patients (48.8%), after a median follow-up of 31.2 months. None of the patients still infected by H. pylori after therapy reached normal platelet values. The long-term follow-up confirms the efficacy of H. pylori eradication in H. pylori-infected ITP patients.

PMID: 15823868 [PubMed - in process]
So one needs to look and eradicate HPylori if you have ITP. "In conclusion, H pylori infection was involved in most ITP patients older than 40 years in Japan, and eradication therapy should be the first line of treatment in H pylori-positive ITP patients."Int J Hematol. 2005 Feb;81(2):162-8.
What about antibiotics and Neurology

1: Lancet Neurol. 2004 Dec;3(12):744-51.
The promise of minocycline in neurology.
Yong VW, Department of Neurosciences, University of Calgary, Alberta, Canada.

The capacity of minocycline to alleviate disease for several neurological disorders in animals is increasingly being recognised. Indeed, that one drug alone can attenuate the severity of disease in stroke, multiple sclerosis, spinal-cord injury, Parkinson's disease, Huntington's disease, and amyotrophic lateral sclerosis is astounding. In this review, we describe the evidence for the efficacy of minocycline in several animal models of neurological disease, discuss the mechanisms by which minocycline affects a range of neurological diseases with diverse causes, and introduce the emerging investigation of minocycline in clinical neurology. The encouraging results of minocycline in experimental neurology bode well for its therapeutic use in human neurological diseases.

PMID: 15556807 [PubMed - indexed for MEDLINE]

Ann Neurol. 2004 May;55(5):756.
Minocycline reduces gadolinium-enhancing magnetic resonance imaging lesions in multiple sclerosis.

Metz LM,

Wiad Lek. 2003;56(11-12):591-3.
[Infectious endocarditis in a patient with multiple sclerosis--case report]
Prystupa A, Mosiewicz J.Katedry i Kliniki Chorob Wewnetrznych Akademii Medycznej

Multiple sclerosis is chronic demyelination disease associated with complex immunological disorders, resulting in increased susceptibility to different infections. A case of woman, aged 40 with multiple sclerosis who was admitted to the Internal Medicine Ward because of severe general state, fever of seven-day duration and systolic murmur in apex area is discussed in this paper. Clinical status and performed diagnostics, among others; echocardiography, blood cultures, abdominal ultrasonography, allowed to diagnose infective endocarditis caused by Enterococcus faecalis. Antibiotics as follows: augmentin, cefuroxim, cefotaxim and vancomycin were administered parenterally. As a result of the treatment normalization of temperature and complete recovery were obtained.
PMID: 15058172 [PubMed - indexed for MEDLINE]

1: Am J Phys Med Rehabil. 1995 Nov-Dec;74(6):415-8.
Role of bacterial infection in exacerbation of multiple sclerosis.

Rapp NS, Physical Medicine , William Beaumont Hospital, Royal Oak, Michigan 48073, USA.

One hundred consecutive patients admitted to the hospital with a diagnosis of exacerbation of multiple sclerosis were evaluated for an infectious process. All patients received a complete blood count, urinalysis, urine culture with susceptibility studies, blood cultures, and a chest x-ray at the time of admission. A control group of 55 patients carrying the diagnosis of multiple sclerosis but without symptoms of neurologic decline were also studied. Thirty-five percent of patients experiencing exacerbation of their disease were identified as having a significant bacterial infection compared with 11% in the control group with quiescent disease. These results were significant with a P value of < 0.001. When presumptive viral and bacterial infections diagnosed before admission were included, almost 50% of patients could have had an exacerbation of their disease in response to an infectious process. Bacterial infection might well play a role in precipitating relapse in multiple sclerosis as well as influencing treatment.
PMID: 8534384 [PubMed - indexed for MEDLINE]

1: Neurology. 2004 Jul 13;63(1):179-80.
Improvement of a CIDP associated with hepatitis C virus infection using antiviral therapy.
Corcia P, Barbereau D, Guennoc AM, de Toffol B, Bacq Y.Department of Neurology, CHRU Bretonneau, Tours, France.

A 57-year-old man with chronic inflammatory demyelinating polyneuropathy associated with hepatitis C virus infection was treated successfully with the combination of peginterferon-alpha-2b and ribavirin. Viral eradication was confirmed during the 4th week of treatment and was followed 3 weeks later by neurologic improvement. The patient resumed normal activity 1 year after the therapy was completed.

PMID: 15249636 [PubMed - indexed for MEDLINE]
1: J Peripher Nerv Syst. 2004 Jun;9(2):98-103.

Chronic inflammatory demyelinating polyneuropathy after Campylobacter jejuni infection mimicking vasculitic mononeuritis multiplex in a diabetic.
Rajabally YA, Sarasamma P, Abbott RJ.

Department of Neurology, University Hospitals of Leicester, Royal Infirmary, Leicester, UK.

Chronic inflammatory demyelinating polyneuropathy (CIDP) is a clinically heterogeneous disorder. Recent reports suggest that CIDP could be more frequent in diabetics. We report here a case of CIDP presenting as mononeuritis multiplex with accompanying cranial nerve involvement in an insulin-dependent diabetic who presented a preceding Campylobacter jejuni infection and misleading skin lesions. Treatment with intravenous immunoglobulins was successful. This case suggests that CIDP should be considered as a potential diagnosis in all diabetics with localized, acute or sub-acute onset, and multiple, or overlapping mononeuropathies.