Rituxan and infections

[Jaha]

I have had 20 Rtx infusions since 2012. It seems like after I have an infusion, I get some kind of an infection and have to be put on antibiotics. I am wondering if when this happens, does that cancel out the effects of Rtx? I have never asked my Doctor about this, but it seems to me that it would take some of the power away from the Rtx. I also noticed that my B cells never just bottom out, in which I unstood that they are supposed to.
I maybe way off track here, but I am wondering if there is something that I just don't get. Please let me know what you all think of this. Thanks!

[Alysia]

Hi jana. Sorry for your infection. Same case here. After each rtx IV I get some infections and or viruses. During the first years it was more UTI's and I was on maintenance of antibiotics for months. I also had lungs infection after the rtx before the last one. After the last one I only got throat infection. I dont think that antibiotics disturb the rtx from working. I can clearly tell when it works on me and calm down the WG, no matter how many antibiotics I take.
Sending you prayers for speedy recovery.

[Jaha]

Alysia,
Thank you for responding to my concerns. I know that I do get to feeling better eventually, but sometimes it is a long road. I also have usually had UTI's after infusions and have to take rounds of antibiotics. This is all a vicious cycle and gets so tiring. Thanks for your prayers. I hope you are doing well my friend.

[blu4runner]

I am fortunate I don't seem to get infections after my RTX infusions and my B cells actually go to 0

[John S]

I get a monthly inhalation treatment of pentamadine antibiotic (I'm allergic to sulfa). I thought that everyone on RTX had to be on some antibiotic since the Rituximab depletes immune system and makes you susceptible to infections.

[MikeG-2012]

I thought that everyone on RTX had to be on some antibiotic since the Rituximab depletes immune system and makes you susceptible to infections.

Not I, haven't had to have one constantly. So far, I have only been on antibiotics periodically for sinus related infections. Otherwise, all has been good for me!

[marta]

I have had 20 Rtx infusions since 2012. It seems like after I have an infusion, I get some kind of an infection and have to be put on antibiotics. I am wondering if when this happens, does that cancel out the effects of Rtx? I have never asked my Doctor about this, but it seems to me that it would take some of the power away from the Rtx. I also noticed that my B cells never just bottom out, in which I unstood that they are supposed to.
I maybe way off track here, but I am wondering if there is something that I just don't get. Please let me know what you all think of this. Thanks!

Hey beautiful Jana,

Nope. The antibiotic doesn't cancel our the Rituxin.
The RTX is a biologic agent targeting only B-cells. Another name for it is B-cell ablation. It gets nearly all of them. They are the ones who initiate the attack based on the memory of having had the virus or bacteria before or from previous vaccines. That's where all the memory of our immune system lies. So after treatment, you're essentially a new born baby when it comes to your immune system. It takes your bone marrow about 6-8 months to regenerate new B-cells. There are some stuck in joints and other places they like to hide, so there's always a little leftover from the time before.

What the treatment does (the part that puts us at risk) is it essentially reboots the computer. Kills any B-cells that thought that your healthy blood vessels were dangerous agents, and it's starting the reprogramming from scratch. It also makes us super vulnerable to infections. Even a mild flu can cause problems where your body is so overtaxed fighting the virus that bacteria can get in and then it's trouble. So taking antibiotics after an RTX treatment is not only not a bad thing, it's actually kind of a good thing because you get a little extra protection from potentially opportunistic bacterial infections.

I use to think (based on discussions here) that taking preventative measures for colds and flus might be counterproductive to our treatment. I've since changed my opinion. I have what I call my 'magic bullet' and I'll take it a few times in a row if I feel the need, and I know it only helps temporarily and doesn't affect the overall treatment. (My magic bullet is 2 oregano oil pills, 2 1000mg Vitamin C, and two 1000IU Vitamin D - above the two I take daily.)

Frett not. The treatment is a big picture thing and is doing it's thing behind the stage. I think taking care of avoiding, and if not then dealing with infections as quick as possible is top priority because in the 'Risk Benefit' part of our treatment, infection is the most dangerous thing we have to worry about once on treatment.

I hope that explained it and didn't make it more convoluted. I'm not great at expressing my ideas clearly and concisely. I'm working on it though.

[Jaha]

Thank you so much Marta, for explaining that to me in a way I can understand. I have never really asked my doctor about that issue.
I am now fighting an infection that has caused a 4cm hole in my thigh and has to be packed. The culture showed it was Heavy anaerobic peptostreptococcus growth species and negative gram bacilli. I am on a really strong antibiotic. I just hope this kills it. Thanks again Marta!

[marta]

Thank you so much Marta, for explaining that to me in a way I can understand. I have never really asked my doctor about that issue.
I am now fighting an infection that has caused a 4cm hole in my thigh and has to be packed. The culture showed it was Heavy anaerobic peptostreptococcus growth species and negative gram bacilli. I am on a really strong antibiotic. I just hope this kills it. Thanks again Marta!

Holy crap Jana,

That's insane. Did you pick it up from the hospital?

I just read up on it. Sounds like a ride, to say the least.
In my 'wanna help brain' I am instantly thinking of other things you could add to the treatment, old wives kinds of things... like colloidal silver, like propolis... but these are just old wive's tales. I know these are things I add to my open cuts to quicken healing, and add an extra level of protection, but that's me. I've also read of out of the box fixes for things like C-dif infection (the antibiotic resistant bacteria you pick up in hospitals and gotta treat with the big guns of antibiotics with a low cure rate) and the new methodology has a 96% cure rate on first treatment and 100% cure rate for second treatment (fecal transplant is the treatment - gross but with 100% success rate, who cares). There is stuff out there that is beyond anecdotal for alternative treatments, I just don't know if there is one for your particular bacterial infection. I'll look it up. I'm curious now.

Sounds like a hard one to wrap your head around, but I'm pretty sure I've seen you go through worse stuff and come out swinging on the other end. I'm sure this experience will be no different. You are a warrior my friend.

In the not too distant future, this'll be a vague memory of "remember that hole in my thigh period? That was wild."

I know this infection will be fixed, and we'll have more stories to share of this crazy ride called Wegener's.

Take care Jana, and if I find anything, I'll send it your way.

Peace.

Post Script: I'm looking around and hyperbolic chamber seems to keep popping up as an aid to healing. Do you have access to one where you live?

[bobjannj]

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