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Garth Nicolson's review of mycoplasma treating protocols

Thursday, January 17 2002 - Filed under: General

Thu, 13 Jan 2000

Certain Mycoplasma species, the smallest and simplest, free-living,
bacteria that lack a rigid cell wall, are important pathogens in animal,
plant and insect species. In humans mycoplasmal infections have only
recently been associated with certain acute and chronic illnesses where
they may function as causative agents, cofactors or more likely as
opportunistic infections that cause patient morbidity. Although various
Mycoplasma species are commonly found as commensals in the oral cavity and
at other superficial sites, certain species appear to cause morbidity when
they penetrate into the blood and spread to and colonize various tissues.
For example, M. hominis and Ureaplasma urealyticum are common inhabitants
of the human genital tract but they can play an etiologic role in
pyelonephritis, pelvic inflammatory diseases and post-abortion and
post-partum fevers. Some reports claim that some Mycoplasma species cause
serious systemic infections, such as septicemia, septic arthritis,
neonatal meningitis and encephalitis, and this has been confirmed in
animal models. For example, M. fermentans can cause severe, fatal
neurological and respiratory signs and symptoms after injection into the
cerebral fluid of rats. Although sometimes questioned, several pathogenic
Mycoplasma species have been proposed to be etiologic agents in various
acute and chronic diseases in man. Less appreciated is the possibility
that multiple chronic infections, including Mycoplasma species, play an
important role in various chronic illnesses and their progression.

Although most Mycoplasma species are probably not a problem to us, there
are several pathogenic species, among them M. fermentans, M. hominis, M.
pneumoniae, M. genitalium, M. penetrans and others, that can cause
significant morbidity if they penetrate and become systemic. These
species start as mainly airborne or urinary tract infections, and although
they are not highly infectious, they can be slowly passed to other

Mycoplasma species are generally sensitive to various antibiotics. The
recommended treatments for diagnosed mycoplasmal blood infections require
long-term antibiotic therapy, usually multiple 6-week cycles of
doxycycline (200-300 mg/day), ciprofloxacin (1,500 mg/day), azithromycin
(500 mg/day) or clarithromycin (750-1,000 mg/day). Multiple cycles are
required, because few patients recover after only a few cycles, possibly
because of the intracellular locations of mycoplasmas like M. fermentans
and M. penetrans, the slow-growing nature of these microorganisms, their
ability to exhibit persistence as dormant forms and their relative drug

Garth Nicolson

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