The information on this site is provided by physicians experienced in the treatment of inflammatory rheumatic diseases with low dose antibiotics according to the protocol developed by the late Dr. Thomas McPherson Brown, . and by many of the multiple thousands of patients who have benefited from this treatment. The website includes all the information necessary to administer this therapy. Physicians should not attempt antibiotic therapy until they have read the protocol completely as this therapy is unlike any other they may be currently using. There are many components to these diseases and their treatment and antibiotic therapy must be tailored to the individual. Treatment periods are usually long and medication and dosage adjustments may be required.
The recommendations in this guidance represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, health professionals are expected to take this guidance fully into account, alongside the individual needs, preferences and values of their patients. The application of the recommendations in this guidance is at the discretion of health professionals and their individual patients and do not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.
Tofacitinib is required by US FDA to have a boxed warning on its label about possible injury and death due to problems such as infections, Lymphoma and other malignancies which can arise from use of this drug.  Serious infections leading to hospitalization or death, including tuberculosis and bacterial, invasive fungal, viral, and other opportunistic infections , have occurred in patients receiving tofacitinib. Epstein Barr Virus -associated post- transplant lymphoproliferative disorder has been observed at an increased rate in renal transplant patients treated with tofacitinib while on immunosuppressive medications. Patients are warned to avoid use of tofacitinib citrate during an "active serious infection, including localized infections." Doctors are advised to use it with caution in patients that may be at increased risk of gastrointestinal perforations. Laboratory Monitoring is recommended due to potential changes in lymphocytes , neutrophils , hemoglobin , liver enzymes and lipids . Tofacitinib claims to have no contraindications , however doctors are advised to reduce the patient's dosage when combined with "potent inhibitors of Cytochrome P450 3A4 (CYP3A4)," such as ketoconazole ), or one or more combined medications that result in both moderate inhibition of CYP3A4 and potent inhibition of CYP2C19 such as fluconazole . Furthermore, immunizations with live vaccines should be avoided by tofacitinib users.