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More Effective Treatment For Pneumonia Following Influenza Found, Study Shows
Science Daily ^ | January 10, 2009 | Jonathan McCullers, M.D et al. [adapted]

Posted on 06/17/2009 4:51:43 PM PDT by grey_whiskers

Scientists at St. Jude Children's Research Hospital have demonstrated a more effective treatment for bacterial pneumonia following influenza. They found that the antibiotics clindamycin and azithromycin, which kill bacteria by inhibiting their protein synthesis, are more effective than a standard first-line treatment with the "beta-lactam" antibiotic ampicillin, which causes the bacteria to lyse, or burst.

The finding is important because pneumonia, rather than the influenza itself, is a principal cause of death from influenza in children and the elderly. During pandemics—such as the one that may arise from avian influenza—up to 95 percent of influenza deaths are due to pneumonia. A bioterrorism attack using the influenza virus would likely result in the same high percentage of pneumonia deaths, according to the researchers.

(Excerpt) Read more at sciencedaily.com ...


TOPICS: Health/Medicine; Miscellaneous; Science; Society
KEYWORDS: ampicillin; antibiotics; azithromycin; clindamycin; cytokinestorm; flu; h1n1; influenza; pneumonia
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Money quote, from further down:

""Traditional first-line therapy has been based on the belief that the bacteria are bad, so we have to get rid of them as quickly as possible," McCullers said. "But what we are finding is that maybe it is the inflammation we need to worry about first, and the bacteria second. Protein synthesis inhibitors shut down the bacterial protein-making factory, and they can avoid the inflammatory burst by killing them over days instead of quickly lysing them."

This may help limit deaths due to pneumonia following infection by flu...

Cheers!

1 posted on 06/17/2009 4:51:43 PM PDT by grey_whiskers
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To: Smokin' Joe; LucyT; 2ndreconmarine; Fitzcarraldo; Covenantor; Mother Abigail; EBH; Dog Gone; ...
Like, *PING*, folks.

Some good news from an unexpected quarter...

Cheers!

2 posted on 06/17/2009 4:53:10 PM PDT by grey_whiskers (The opinions are solely those of the author and are subject to change without notice.)
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To: neverdem

ping


3 posted on 06/17/2009 4:54:28 PM PDT by metmom (Welfare was never meant to be a career choice.)
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To: metmom

THANKS, bfl


4 posted on 06/17/2009 5:01:34 PM PDT by neverdem (Xin loi minh oi)
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To: grey_whiskers; Smokin' Joe; null and void; WestCoastGal; Rushmore Rocks; Oorang; Velveeta

Thanks, Grey_Whiskers. Another article that might be of interest.

Miracle Man Survives Deadly Virus With New Surgical Procedure

Local Houston Man, Darren Pangle, Survives Rare Pneumonia Virus; Recently Saved At St. Luke’s Hospital

HOUSTON June 10, 2009 — In February, doctors and medical personnel at St. Luke’s Hospital were amazed at the results of an ongoing research project that saved the life of a 43 year old Darren Pangle.

Headed by cardiologist, Dr. Pranav Loyalka, of St. Luke’s Hospital, a machine was attached via tubes surgically placed in his groin, to aide in the oxygen exchange in the lungs, which then provided time in the healing process of a mutant strain of pneumonia virus.

This procedure, relatively new to the medical world, has a survival rate of only 38%.

More:
http://www.pr-inside.com/miracle-man-survives-deadly-virus-with-r1326953.htm


5 posted on 06/17/2009 5:18:11 PM PDT by LucyT
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To: grey_whiskers; AdmSmith; Berosus; bigheadfred; Convert from ECUSA; dervish; Ernest_at_the_Beach; ...

Thanks grey_whiskers.


6 posted on 06/17/2009 5:20:00 PM PDT by SunkenCiv (https://secure.freerepublic.com/donate/__Since Jan 3, 2004__Profile updated Monday, January 12, 2009)
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To: grey_whiskers

This has some problems. To start with, secondary bacterial pneumonia is more typical of normal influenza, and they specify young children and the elderly-infirm which again are typical.

However, the radically different influenza for which there is little or no immunity or partial immunity, has different rules. Its primary victims are those from about age 20-45, with healthy and strong immune systems. This is because their immune system itself attacking the virus, not secondary bacteria, is what is destroying their lungs.

For these young and healthy people, it is essential that lethal Acute Respiratory Distress be prevented in the first place. And there are some very positive things that can be done right now to fend off ARD during an epidemic.

The first thing is to eliminate possible sources of Arsenic from your environment. Small amounts of Arsenic, over time, have been found to inhibit the immune system pathogen recognition system. So in the case of influenza, first the body doesn’t recognize the disease, and then it overreacts to it, causing ARD.

Fortunately, the EPA has strict limits on Arsenic in city water, so only rural wells present a drinking water - influenza risk. But 90% of the other Arsenic in our environment is used as wood preservative.

Statin drugs, normally used for high cholesterol, like Lipitor and Crestor, have been found to strongly inhibit ARD.


7 posted on 06/17/2009 5:45:07 PM PDT by yefragetuwrabrumuy
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To: yefragetuwrabrumuy
Thanks for the pointers; I had been under the impression that in *some percentage* of the cases of H1N1, people "recovered" from the initial viral infection, then suddenly spiraled downhill, due to secondary opportunistic lung infections.

I appreciate your taking the time to correct me courteously.

Also--if I may be so bold as to ask--do you have any further information on the role of arsenic in the CFR for H1N1? I had read of such about a month or so ago, but have found no follow-ups.

I knew about the statins, but I am not on them...

Cheers!

8 posted on 06/17/2009 5:59:45 PM PDT by grey_whiskers (The opinions are solely those of the author and are subject to change without notice.)
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To: grey_whiskers

I may have led you astray there. I would imagine a strong likelihood of lethal secondary pneumonia infections from novel influenza; however, these will be so horribly overwhelmed by the cytokine storm mortality numbers as to be almost unnoticeable.

Arsenic and influenza:

http://www.newswise.com/articles/view/552624/

I would also add that there is a four-drug recipe targeting some of the major components of the (about 150) cytokine response elements, which may be enough to settle down the immune system until the threat is passed. Only one of the four is prescription, and it has an OTC substitute.

The first is an ACE-2 inhibitor, normally prescribed for hypertension. Its substitute is 15,000 IU of Vitamin D for two weeks.

The second drug is a Histamine-1 blocker. Ordinary Benedryl.

The third drug is a Histamine-2 blocker. Tagamet, usually used for acid reflux.

The fourth drug is Advil, Ibuprofen. It is a prostaglandin blocker.

Importantly, all four drugs have to be taken for the hoped for effect of stabilizing the immune response.

And, of course, the fifth drug, which is independent of the recipe, is a statin drug, such as Lipitor or Crestor, which according to data mining from a 16,000 person medical records sample group, makes somebody 40% less likely to die from Acute Respiratory Distress *and* Pneumonia.


9 posted on 06/17/2009 6:50:05 PM PDT by yefragetuwrabrumuy
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To: yefragetuwrabrumuy
Thanks, bookmarked for later.

Do you take the 4 OTC medications as a prophylactic, or shortly after infection -- except for the Vitamin D, which you should do for two weeks?

Cheers!

10 posted on 06/17/2009 7:08:58 PM PDT by grey_whiskers (The opinions are solely those of the author and are subject to change without notice.)
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To: 2ndreconmarine; Fitzcarraldo; Covenantor; Mother Abigail; EBH; Dog Gone; ...

Ping...(Thanks, grey_whiskers!)


11 posted on 06/17/2009 7:44:04 PM PDT by Smokin' Joe (How often God must weep at humans' folly. Stand fast. God knows what He is doing.)
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To: yefragetuwrabrumuy

Turmeric (in the form of high potency curcuminoids) has a pronounced anti-cytokine effect. Many published papers returned on a search of curcumin+cytokine. Curcumin is resident in my flu kit.

A couple of months ago I posted the statin study showing the protective effect against ARDS. An anti-psychotic drug has also been used for its anti-cytokine effect but at the moment which one escapes me.


12 posted on 06/17/2009 8:02:10 PM PDT by steve86 (Acerbic by nature, not nurture)
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To: grey_whiskers

Typically, ARD happens about 5 days into avian influenza. But when and for how long the treatment should be conducted optimally is still unknown. However, all else being equal, going maximum dose for 5 days would be my choice.


13 posted on 06/17/2009 8:48:36 PM PDT by yefragetuwrabrumuy
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To: grey_whiskers
My first serious pneumonia following flu was treated with erythromycin. It certainly hit the bacterial population hard, but the secondary effects were a fever spike to 103.5 that persisted for 3 weeks. Some of the bacteria that persisted were proteolytic and left the back of my throat looking like it had been cut deeply with a knife along the drainage path from sinuses to lungs. The garbage in my lungs was a mix of blood, pus and mucous with a very acidic characteristic. It took almost 3 months for my lungs to completely clear. After that pneumonia, my lung capacity was never very good again. I tried very hard to excel at inline speed skating, but always ended up hypoxic when I pushed my limits.

The study results seem to mirror the advice for treatment of anthrax as well. A slow, steady kill of the germinated organisms achieves the objective without dumping a large volume of toxins into the patient at one time. The antibiotics that cause a breach of the bacterial wall dump the endotoxins out in one broad step. Many of the fever producing toxins are endotoxins. That likely explains my own experience.

14 posted on 06/17/2009 9:17:41 PM PDT by Myrddin
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To: yefragetuwrabrumuy
My dad was hit by ARD after sweeping up ashes from the fires in the Fall of 2003 in San Diego. The doctors couldn't stop it. He progressed from oxygen tent to CPAP to intubation over a 36 hour time frame. The mucous in his lungs finally jammed the tube. That wasn't discovered until his heart arrested from lack of oxygen. He was "revived" after 20 minutes of heroics, but his brain was wiped out by then. Over the next few days other organs began failing. He had a DNR request on file if he progressed to that level of failure.
15 posted on 06/17/2009 9:24:20 PM PDT by Myrddin
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To: yefragetuwrabrumuy
You've listed my "night time formula". I'm only taking 2,000 IU of vitamin D, but the nightly regimen includes ibuprofen, benedryl and an antacid to prevent the continued dissolution of my back teeth by excessive stomach acid. The ibuprofen shuts down the back pain from arthritis enough to allow me to sleep. The benedryl stops my skin from itching, eyes watering and itching and nose running. The vitamin D supplement compensates for insufficient exposure to sunlight at my latitude AND my propensity to burn and peel.
16 posted on 06/17/2009 9:32:43 PM PDT by Myrddin
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To: Myrddin

Have a caution with the regular consumption of Vitamin D. Unlike other vitamins, it is a hormone, and your body will adjust itself accordingly, producing less natural Vitamin D. Instead of a supplement, I would recommend a natural light sun lamp. Just 15 minutes should give you a whopping natural dose.

As far as Ibuprofen for pain, I’m one of those individuals who never profited from conventional NSAIDs. However, I was eventually prescribed Celebrex, which I found to be the first pain reliever I had ever taken that worked. A different class of drug entirely.

Other things of potential interest. Researchers in Africa made the interesting discovery that people who had very low levels of Vitamin A, due to dietary deficiency, also had unusually high levels of Tumor Necrosis Factor alpha (TNF-1), which is often a major part of arthritis.

Just bringing up their Vitamin A to normal levels as much as halved the amount of TNF-1 in their blood. Importantly, even with severe deficiency, they had to be careful how much of the Vitamin to give, and over what time period, because it is so easy to overdose.


17 posted on 06/17/2009 9:51:41 PM PDT by yefragetuwrabrumuy
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To: yefragetuwrabrumuy
Have a caution with the regular consumption of Vitamin D. Unlike other vitamins, it is a hormone, and your body will adjust itself accordingly, producing less natural Vitamin D. Instead of a supplement, I would recommend a natural light sun lamp. Just 15 minutes should give you a whopping natural dose.

Details, (or more precisely, source), please?

I may have to invest in a sun lamp, living in Minneapolis.

Cheers!

18 posted on 06/18/2009 4:18:59 AM PDT by grey_whiskers (The opinions are solely those of the author and are subject to change without notice.)
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To: grey_whiskers

http://www.sciencealert.com.au/news/20092404-19052.html


19 posted on 06/18/2009 5:38:24 AM PDT by yefragetuwrabrumuy
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To: yefragetuwrabrumuy; Mother Abigail; EBH; vetvetdoug; Smokin' Joe; Global2010; Battle Axe; ...
It had been my understanding that Staph. aureus was the likely suspect for the secondary pneumonia after seasonal influenza. I started coughing up blood streaked sputum, renewed fever and chills after a bout of flu around Christmas, 2000. I took azithromycin.

Treatment with protein synthesis inhibitors improves outcomes of secondary bacterial pneumonia after influenza.

Pneumonia occurring as a secondary infection after influenza is a major cause of excess morbidity and mortality, despite the availability and use of antibiotics active against Streptococcus pneumoniae. We hypothesized that the use of a bacteriostatic protein synthesis inhibitor would improve outcomes by reducing the inflammatory response. BALB/cJ mice infected with influenza virus and superinfected with S. pneumoniae were treated with either the cell-wall-active antibiotic ampicillin or the protein synthesis inhibitor clindamycin or azithromycin. In the model, ampicillin therapy performed significantly worse (survival rate, 56%) than (1) clindamycin therapy used either alone (82%) or in combination with ampicillin (80%) and (2) azithromycin (92%). Improved survival appeared to be mediated by decreased inflammation manifested as lower levels of inflammatory cells and proinflammatory cytokines in the lungs and by observation of less-severe histopathologic findings. These data suggest that beta-lactam therapy may not be optimal as a first-line treatment for community-acquired pneumonia when it follows influenza.

20 posted on 06/18/2009 1:34:20 PM PDT by neverdem (Xin loi minh oi)
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