Fluconazol neuroborelioza link do badan

F. W. Schardt

Clinical Effects of Fluconazole in Patients with Neuroborreliosis

Abstract

Eleven patients with neuro-borreliosis had been treated with 200 mg fluconazole daily for 25 days after an unsuccessful therapy with antibiotics. At the end of treatment eight patients had no borreliosis symptoms and remained free of relapse in a follow-up examination one year later. In the remaining four patients, symptoms were considerably improved. At the end oftherapy immune reactivity (lgl\/l+) disappeared in three patients. Since borrelia spp. are almost exclusively localised intracellular, they may depend on certain metabolites of their eucaryotic host cell.

Inhibition of P450 and other cytochromes by fluconazole may incapacitate Borrelia upon longterm exposure.

.,, ......  Fluconazole achieves high concentrations in many tissues as well as in CSF [20, 21,22, 23, 24, 26, 27, 28, 32, 33]. No previously published data exists on efficacy of fluconazole against Borrelia in vivo. In vitro investigations failed to reveal a direct antibacterial effect of fluconazole on Borrelia spp [34]. Concerning the mechanism of the therapeutic effect observed in our patients, we may speculate on a potential bacteriostatic impact of fluconazole due to its inhibitory action on cytochrome P450.

Since in vivo Borrelia spp. are almost exclusively localized intracellularly, they may depend on certain metabolites oftheir eucaryotic host cell for replication and long-term persistance [35]. Inhibition of P450 and other cytochromes may incapacitate

Borrelia spp. upon longterm exposure. This appears to correlate with the fact that in this study improvement/cure was observed in most cases only after 25 days of fluconazole treatment. Perhaps a longer therapy could have improved the results ..... ,,


http://www.neuroborreliose.net/downl.../neuroborreliosis.pdf.