The Use of Dapsone as a Novel Persister Drug in the Treatment of Chronic Lyme Disease/Post Treatment Lyme Disease Syndrome
|Richard I. Horowitz* and Phyllis R. Freeman|
|Hudson Valley Healing Arts Center, New York, USA|
|*Corresponding Author :||Richard I. Horowitz
Derpartment of Dermatology
Hudson Valley Healing Arts Center
4232 Albany Post Road
Hyde Park, New York 12538, USA
|Received date: March 04, 2016; Accepted date: April 02, 2016; Published date: April 08, 2016|
|Citation: Horowitz RI, Freeman PR (2016) The Use of Dapsone as a Novel “Persister” Drug in the Treatment of Chronic Lyme Disease/Post Treatment Lyme Disease Syndrome . J Clin Exp Dermatol Res 7:345. doi:10.4172/2155-9554.1000345|
|Copyright: © 2016 Horowitz RI, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
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Dapsone (diaminodiphenyl sulfone, i.e., DDS) is commonly used to treat dermatological conditions including acne, dermatitis herpetiformis, and leprosy. Mycobacterium leprae, a known "persister" bacteria, requires long-term treatment with intracellular medications including rifampin and Dapsone. Other "persister" bacteria recently have been identified, including Borrelia burgdorferi, the agent of Lyme disease.
Objectives: We tested the efficacy of DDS in patients with chronic Lyme disease/PTLDS with tick-borne coinfections including Babesiosis, who failed commonly used antibiotic and antimalarial protocols.
Methods: 100 patients with Lyme disease, 56 of who were Babesia positive, were placed on Dapsone and folic acid in combination with either one or two other intracellular drugs, including rifampin, tetracyclines, and/or macrolide antibiotics. Several patients also took cephalosporins, and all patients were on protocols to treat cystic forms of Borrelia and biofilms.
Results: Patients completed a symptom severity survey before beginning treatment with Dapsone and then again after at least one month of treatment scoring their complaints from 0 indicating “none” to 4 indicating “severe” for symptoms including fatigue, joint and/or muscle pain, disturbed sleep, and cognitive difficulties. Results demonstrated that Dapsone significantly improved all patients’ clinical symptoms except for headache, where changes did not reach statistical significance. In addition, Dapsone, known to have anti-malarial effects, helped resistant Babesia symptoms of sweats, chills, and flushing. Lyme positive, Babesia positive patients also demonstrated significant changes in pain, disturbed sleep, and cognitive difficulties. Side effects included macrocytic anemia and rare cases of methemoglobenemia, which resolved by either decreasing the dose of Dapsone or increasing folic acid.
Conclusion: Dapsone is a novel and effective “persister” drug for those with PTLDS and associated tick-borne co-infections who have failed classical antibiotic protocols. Further prospective trials must determine the DDS dose, length of treatment and best combination antibiotic therapy in order to effect a long-term health benefit.
Dapsone; Rifampin; Chronic Lyme disease; Post Treatment Lyme Disease Syndrome (PTLDS); Biofilms; Babesiosis; Tick-borne co-infections; “Persister bacteria”; Morgellon’s syndrome; Multisystemic infectious disease syndrome
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