This summer I presented
details at a gathering
international scientists, outlining some major changes which appear to be taking
place in orthodox medicine. One of those changes concerned a more critical
approach to some conventional medical treatments, which so far have been used
extensively and were considered to be 'safe'.
One such treatment approach
relates to antibiotic use in general. This has come under severe scrutiny in
recent years, not only from practitioners in the complementary sector, but at
various levels also within the orthodox establishment and in the public domain.
At the official level, a 1993
(World Health Organization)
report stressed that antibiotics were used too frequently and often
inappropriately for coughs, colds, sore throats and respiratory tract
infections, especially in children and frequently because
Secondary infections were
uncommon, antibiotics for viral infections useless and could be harmful (1).
As long ago as April
Richard Lacey, Consultant Microbiologist, Leeds University, stressed there was
growing evidence of bacterial resistance to antibiotics in a World in Action
programme SUPERBUG. He then referred to Septrin, one of many brand names of the
frequently prescribed broad-spectrum antibiotic known generically as Co-
Trimoxazole, as a 'highly dangerous drug'. which in his view should never have
been released for general use.
Co- Trimoxazole usually
consists of five parts Sulphamethoxazole (a sulphonamide) and one part
Trimethoprim (a powerful antibacterial agent). It is also available under many
other brand names, notably as Bactrim in the USE and elsewhere, and has been
prescribed world-wide since 1969 for many infections, from acne to pneumocystis
pneumonia in AIDS patients, but particularly for cystitis and urinary tract
infections. Professor Lacey attributed its toxicity to the sulphonamide
Three major articles by Brian
Deer published in The Sunday Times on the pharmaceutical company Wellcome(2,
4) brought problems with Septrin into the public
domain. A flood of letters from injured people followed, and a significant
number were suffering from a 'seemingly disabling and unrecognized syndrome'
This came as no surprise to
me. I had identified this particular antibiotic as possibly playing a
significant role in the onset and/or development of M.E. (Myalgic
Encephalomyelitis) in some sufferers, based on questionnaires, which formed the
basis of a
large multifactorial MSc
study into this disorder (5).
Not only had about one in
every three females been prescribed this drug on one or more occasions for a
variety of health problems (e.g. acne, sinusitis, tonsillitis, and especially
cystitis and urinary tract infections) before developing ME or CFS (Chronic
Fatigue Syndrome), as some doctors prefer to refer to this illness, but what
worried me were an
number of reported severe reactions to it. Antibiotic use was one of several
link factors I looked at in my study, but I soon realized it was likely to be an
important one. Other factors related to
oral contraceptives, stress and diet.
Some unexpected links
emerged as well, such as exposure to toxic chemicals, pesticides and powerful
electromagnetic fields. I was not alone in observing the frequent use of
antibiotics prior to development of ME, CFS or CFIDS (Chronic Fatigue Immune
Dysfunction Syndrome), the preferred American description. Carol
Jessop found that
1300 CFIDS patients were
candida (a Superinfection which can
occur after antibiotic
treatment) and devoid
flora after purged
stool specimens, and 84% had recurrent
and prolonged antibiotic treatment (6).
Many others have made similar observations.
Following the publication
Deer's articles, Professor Lacey, a longstanding opponent of Septrin,
addressed two meetings of' SeptrinSufferers. The first was arranged by Zofia
Mescall at High Wycombe in August, 1994 and led to the formation of the Victims
of Septrin group; the second was arranged by
Nina Hogan in
September, 1994 and
led to the formation of the Septrin Action Group. The aims of both groups were a
complete ban or severe restriction of
drug and the Septrin Action
Group also consulted solicitors with a view
to taking legal action against the manufacturers.
I related these developments,
the potential hazards of Co-Trimoxazole (Septrin) and Professor Lacey's 'Case
InterAction, the journal of
the ME patient organization Action for M.E.
(7). Of particular
significance appeared to be the drug's powerful
inhibition of folic
which is essential for bacterial growth. Thus it
effectively controls infections. However, folic acid is also essential for the
activities of several enzymes and the manufacture of nucleic acids, the genetic
material of cells, and hence for the processes of growth and reproduction. It is
also vital for the formation of red blood cells by the
bone marrow and the proper
central nervous system (CNS).
Deficiency can lead to
abnormally low numbers of red blood cells (anaemia). The resulting main symptoms
include fatigue, loss of appetite, nausea,
diarrhoea and hair loss (8).
Lacey in his enlightening talks also stressed the
effects this drug can have on the skin, leading in severe cases to
Stevens-Johnsons Syndrome, a potentially life-threatening reaction, and
long-term problems in the form of blood dyscrasias (diseased constitution), as
well as the common destruction of white cells, which fight infections, thereby
rendering people more vulnerable to infections. Since many of these problems are
part of the ME complex of symptoms, the significance of Septrin in the
development and/or onset of ME began to dawn on me.
During the latter half of
1994 and early 1995 the issue of safety of Septrin received much media
publicity, both at a local and national level. The most forceful probably was a
BBC2 Newsnight item shown on 5.1.1995, in which the ex Chairman of the CSM
(Committee on Safety of Medicines) stated he felt future use of CoTrimoxazole
should now be limited by law, and the ex Director of the ABPI (Association of
British Pharmaceutical Industries) declared that with the knowledge of
hindsight, this drug would probably not have received a product licence in 1994.
It was also announced that
Wellcome made a profit of £47 Million in 1993 from the sale of Septrin alone.
In early March,
1995 the Victims of
Septrin Group, presented the Chairman of the CSM
and the Attorney General with a petition of 1000
signatures, calling for a ban of all brands of Co- Trimoxazole and Trimethoprim,
200 case histories selected from over 1000, and dozens of personal accounts of
injuries sustained from these drugs. They also copied in the BMA (British
Medical Association), all Health Authorities in England, Scotland and Wales,
several MPs and the media. The issue was debated in the House of Commons on
22.3.1995. The drug was placed under full review from 1.5.1995 and on 6.7.1995
Junior Health Minister Tom Sackville announced that its future use would be
severely restricted in the UK (9).
By July 1995, 28 ME sufferers had written to Action for ME in response to
my article 'Septrin -
The Aftermath' (7),
reporting very severe reactions to these drugs, some horrific experiences and
how they linked development or onset of their ME to their use.
Even more people contacted
the Victims of Septrin and/or the Septrin Action Groups. Details of the 28
direct responses were given to the Chairman of the CSM and other drug regulatory
Additional questionnaire data
on 25 of these subjects enabled me to submit an,
Cases to the First
World Congress on CFS and Related Disorders
scheduled for November, 1995 in Brussels, Belgium. This was accepted for poster
presentation and full details were shown at
this event (10).
The adverse reactions
reported by these
subjects were even more
severe than those reported by subjects of my earlier MSc study group. Again,
cystitis and urinary tract infections were most prominent, and adverse reactions
included severe skin rashes, immediate collapse and anaphylaxis, as well as
muscle/joint pains and hair loss. Apart from having to cope with a crippling new
illness, the main problems these subjects often had was to convince their GPs of
the nature and significance of these adverse reactions.
However, as details of my
latest study indicated, not only did Septrin cause severe reactions, and
apparent subsequent ill health in susceptible individuals, but so could, less
frequently, the single agent Trimethoprim, which was believed to be a safe drug.
The December, 1995 Drugs and Therapeutics Bulletin, an independent review for
doctors and pharmacists from the Consumers' Association, contained a review of
the Co- Trimoxazole restriction and guidelines for future use (11).
They refer to earlier publications, urging doctors to use a single antibiotic in
preference to the Co- Trimoxazole combination. By
the CSM had received
reports of 127 deaths associated with Co-Trimoxazole and 15 deaths linked
to Trimethoprim, but true comparisons of the exact incidence of toxicity could
not be made for a number of given reasons. They concluded: 'The change in the
licensed indications for Co- Trimoxazole means that, in practice, there will be
few occasion, apart from pneumocystis pneumonia (in AIDS) in which this drug
should be prescribed in preference to a single antibiotic'.
A literature search revealed
that not only were very severe reactions to Septrin documented in major medical
journals and publications, but so were severe reactions to Trimethoprim given on
its own, particularly if patients had an earlier adverse reaction to Co
Trimoxazole. A restriction along UK lines was imposed in Sweden in the mid
1980s. A summary of the Septrin developments and possible dangers of
Trimethoprim were published in 'What Doctors
Don't Tell You' (12).
Since the autumn of 1995,
sufferers have sent
details of their experiences with Septrin, Bactrim and/or Trimethoprim and
ME, some responses
coming from America, Canada and elsewhere.
sufferers were prescribed
these drugs is uncertain and exactly how,
or indeed if, their use may have contributed to the development of their
subsequent illness remains to be established. One thing is certain though: Many
problems seen in ME are also documented as possible side effects following the
use of CoTrimoxazole.
This may be just a
coincidence, but with growing evidence of the involvement of toxic substances
like organophosphate pesticides in the
development of this disorder (13),
it seems feasible that this now restricted
antibiotic could also have played a crucial role.
Only time will tell.
Meanwhile concerns over
antibiotics were expressed in Geoffrey Cannon's book SUPERBUG
Revenge (14). These
details were also discussed in a BBC1 Panorama programme with the same title,
shown on 15.1.1996.
Of particular concern now are
MRSA (Methicillin Resistant Staphylococcus Aureus), a bacterium which is
resistant to most antibiotics, except Vancomycin, and VRE (Vancomycin-Resistant
Enterococcus), which is resistant to all antibiotics. A further WHO report
expressed similar concerns, particularly on TB.
So are we looking at a
Doomsday scenario? And if this is so, why were the dangers of antibiotic use, so
well documented in the pharmacological
adamantly ignored by medical practitioners?
It seems it is time for a
thorough reassessment of the most appropriate and effective use of these
powerful magic bullets, which have saved so many lives in the past, and could
still do so if used carefully and sensibly.
Hicks C. Too many
antibiotics. The Independent, 4.5.1993.
Deer B. Hard Sell.
The Sunday Times, News Review, 27.2.1994:1-2.
Deer B. The Money
Spinners. The Sunday Times, News Review, 6.3.1994:1-2.
Deer B. The Pill
that Killed. The Sunday Times, 20.3.1994:16.
Jones DM. M.E..
Just one silent epidemic. MSc thesis. University of East London,
Jessop C. Clinical
features and possible aetiology of CFIDS. The CFIDS Chronicle,
Jones DM. Septrin -
The Aftermath. InterAction 17,Autumn, 1994:25-27.
Henry J. The BMA's
New Guide to Medicines and Drugs. Dorling Kinders-Iey, 1994:131,424.
Choo V. UK revises
indications for CoTrimoxazole. The Lancet 1995; 346:175.
Jones DM. Co- Trimoxazole/Trimethoprim
ME Cases. Poster presentation, First World Congress on Chronic
Fatigue Syndrome and Related Disorders, Brussels, 9-11.11.1995.
Therapeutics Bulletin, December, 1995, Vol.33 No.12:92-93.
Septrin's 'safe' substitute. What Doctors Don't Tell You, January,
1996, Vol.6 No.10:12.
Organo-Phosphate Poisoning. Yoga & Health, August, 1996: 29-31;
Superbug, Nature's Revenge. (Why antibiotics can breed disease).
Virgin Publishing Ltd., 1995.
al. Pharmacological Basis of Therapeutics, 1985: 1137; 1091.
Duke MNG. Side
Effects of Drugs. Excerpta Medica, 1983;Ch26:271-93.
Effects of Drugs. Elsevier, 1984;Ch26:446-75.
D'Arcy PF et al.
Iatrogenic Diseases. OUP 1979 - diverse references.
Invest in ME are
grateful for permission from the editor of YOGA & HEALTH
for permission to reproduce the above article.