A specific question has been asked a lot lately, as to what is my protocol for handling Biofilm. Most of these questions have been directed to me by those diagnosed with or think they may have H. pylori bacterial infection or Lyme’s Disease (See also: Biofilms of Borrelia burgdorferi And Clinical Implications for Chronic borreliosis by Alan B. MacDonald, MD). The reason that I’ve put this “biofilm protocol” post together is because of this fact: the day I discovered how to handle biofilm in the body, was the day that chronic conditions, from the sinus to the prostate, were no longer a ‘project’, so to speck, to handle. I hope this information is helpful to you.
First a little background on biofilm:

Fig. 1: The biofilm life cycle. 1: individual cells populate the surface. 2: extracellular polymeric substance (EPS) is produced and attachment becomes irreversible. 3 & 4: biofilm architecture develops and matures. 5: single cells are released from the biofilm. Related Post – Biofilm Basics and Quorum Sensing and Biofilm
This is an excerpt from a Klaire Labs product monograph which is a basic primer on the topic (My additions are in RED) The National Institutes of Health estimates that 60% of all human infections and 80% of refractory infections (def. unresponsive to medical treatment) are attributable to biofilm colonies. I have seen this, most commonly, in cases I’ve worked-up, where the pathogen is: Chlamydia pneumoniae, Pseudomonas aeruginosa, Helicobacter pylori, [Lyme disease - Borrelia burgdorferi] and Candida albicans.
- The protection conferred upon microorganisms by biofilm allows them to achieve a high level of antibiotic resistance, stealth and invisibility.
- Biofilm not only provide a physical barrier to antimicrobial agents (pharmaceutical antibiotics) and host antibodies, but facilitate the exchange of antibiotic-resistant genetic material between organisms and may contain antibiotic-degrading (hydrolysing) enzymes such as b-lactamase, effectively neutralizing incoming antibiotic (b-lactam antibiotics) molecules.
- In fact, biofilm communities can be 1000 times more resistant to antibiotics than free-floating bacteria.
- The decreased growth rate of sessile microorganisms (def. Permanently attached to a substrate; not free to move about; “an attached oyster”) also reduces their antibiotic susceptibility as most antimicrobial agents require rapid cell growth in order to effectively kill or inhibit the microbes. Biofilm thus render pathogenic microorganisms enormously difficult to eradicate, and can almost single-handedly contribute to localized or systemic inflammatory reactions and delayed wound healing.
- Depending on the type of biofilm, one or more species of pathogens may be found embedded in the extracellular polymeric substance (def. Composed primarily of polysaccharides and can either stay attached to the cell’s outer surface, or be secreted into its growth medium). Bacterial extracellular polymeric substance (EPS) maybe a carrier of, or may have heavy metals embedded in them, thus the indication for chelation w/EDTA. EDTA, ethylenediaminetetraacetic acid, is a chelating agent used to lower one’s body burden of heavy metals).
Pathogenic bacterial known to reside in biofilms include, but are not limited to: Borrelia burgdorferi (Lyme bacteria), Escherichia coli, Candida albicans (yeast and fungal mutation), Clostridium difficile (the most common cause of GI infection and a growing epidemic), Clostridium perfringens, Helicobacter pylori, Klebsiella pneumoniae, Legionella pneumophila, Listeria monocytogenes, Pseudomonas aeruginosa, Salmonella typhimurium, Staphylococcus aureus, Staphylococcus epidermidis, and Vibrio cholerae. Chlamydophila species such as Chlamydia pneumoniae don’t form biofilm, as they are intercellular, but may some how get accidentally get caught-up in them before entering a host cell. Here is a good video on Chlamydia and biofilm (Video [biofilm section 7:45 min. mark] – Dr. Wilmore Webley on C. pneumoniae & Biofilms).
The number of human diseases shown to be associated with biofilms is ever expanding and includes: chronic bacterial prostatitis, chronic rhinosinusitis (chronic sinus infections), cystic fibrosis pneumonia, infective endocarditis, periodontitis, recurrent otitis media, and virtually all device and implant related infections. Strong evidence is also beginning to emerge for an etiologic (causative) role of pathogenic mucosal biofilm in gastrointestinal diseases, such as Irritable Bowel Disorders (IBS): Crohn’s disease and ulcerative colitis.

S. aureus biofilm
Dr. Marcus Ettinger’s Biofilm Protocol – Only the eradication phase is presented here. There is a pre, post and toxin reduction step as well. You can get help with any of these steps by going HERE.
A. Products (mandatory products in red). These are ONLY the basics. Additional nutraceuticals may be needed, based on each individuals unique situation.
- Monolaurin or Lauricidin [AKA Glyceryl laurate or glycerol monolaurate] (monolaurin information).
- Nutiva Extra-Virgin Coconut Oil (42-52% Medium Chain Fatty Acids [MCFA], lauric acid, by volume)
- Nattokinase (a potent fibrinolytic enzyme) Some prefer Lumbrokinase.
- InterFase Plus™ (broad-spectrum enzyme formula w/EDTA)
- Serrapeptase (a potent fibrinolytic enzyme)
- Vitamin C (ascorbic acid – Not buffered, as most of these contain metals)
- NAC (N-Acetyl-Cysteine)
- Lactoferrin (I like Nutricillin by Ecological Formulas) Dr. Anju Usman of Illinois states, “Our bodies make proteins, transferrin and lactoferrin, which mop up iron and block the ability of biofilm to form,” she said. “But pathogenic bacteria secrete iron chelators to snatch up iron and thus compete with the transferrin and lactoferrin for what they need to survive.”
B. Avoid supplemental forms of: iron, magnesium and calcium during the biofilm protocol, as they may contribute to biofilm formation or increasing biofilm density, thus decreasing the overall effectiveness of the biofilm protocol.
C. Take a broad-spectrum probiotic and prebiotic. I like Now Foods brand Probiotic-10. VSL-3 can also be used as well as Elaine Gotschall’s SCD™ yoghurt. These products will help to crowd out the bad bacteria, and also help disrupt and replace biofilm colonies along the mucus membrane.
D. Specific additions based on condition (not a complete list):
- Candida albicans – SF722* (10-Undecenoic Acid 50 mg) Thorne Research. This is as close as you can get to a medication and still be a natural substance. There are a few chat rooms blasting this product, based on who knows what – can’t make everyone happy. I’ve used SF722 for over 15 years and it is amazing – never a problem! *Do not take SF722 if you are allergic to fish. ADP by Biotics Research is also a dynamite product. There are many other amazing products that can be added to complement the SF722 and ADP. It’s really a matter of how many pills someone wants/doesn’t want to take per day or the severity of one’s condition, that will determine, if or which, additional products will be added. If the Candida albicans overgrowth is severe, has not responded to holistic methods or has mutated into its more virulent hyphal form/fungal infection (nails, underarms, groin or skin); Diflucan (fluconazole), a prescription medication, is my personal preference, but Nizarol (ketoconazol) can also be used. In Azole-resistant Candida albicans, lactoferrin must be added to either medication in order to increase their effectiveness. There is a certain B vitamin, mineral and amino acid that possesses synergistic qualities and I find them indispensable when taking Diflucan (fluconazole), Nizarol (ketoconazole) or for supporting candida die-off symptoms.
- Chlamydia pneumonia, Klebsiella pneumoniae or Pseudomonas aeruginosa – Pneumotrophin PMG by Standard Process, Inc. How it works. I use this because it helps direct the body’s attention and healing efforts to the lung, where it’s needed most. Apex Energetics, H-PLR is also a mandatory addition. I also like to use OOrganik-15™ and Pneuma-Zyme™ by Biotics Research with some of my patients who manifest asthma, a chronic cough and/or emphysema like symptoms.
- H. pylori Protocol – Heartburn/gastritis/GERD or achlorhydria or H. pylori?
- Chronic bacterial prostatitis – Quercitin (600mg’s) and Bromelain (200mg’s) combination by Now Foods. Decreases inflammation and oxidant stress in the prostate while increasing local concentrations of beta-endorphins. Apex Energetics, H-PLR is also a mandatory addition.
E. Certain dietary restrictions and additions will need to be taken. These are determined on a case by case basis.
Important Note:
All dosages will be provided if you purchase some or all of your “biofilm protocol” products through my office. I truly do want to help all who are interested, but it’s finally gotten to the point where too many people want free advice and an increasing amount of my time, and then buy all of their products elsewhere. I am a firm believer in fair-exchange and I feel I have done that by providing the information in this post.
I also offer tailor made protocols for your individual situation, please contact our office for product prices and distance patient information (714) 639-4360.
Biofilm testing is also available through Fry Laboratories. Fry Laboratories, L.L.C. is an independent clinical diagnostic and research laboratory located in Scottsdale, Arizona. We are committed to understanding chronic diseases and contributing to their cure through advancements in diagnostics and basic science research with emphasis on chronic inflammatory diseases, vector-borne diseases, and their intersection. Our clinical diagnostic laboratory offers general and targeted immunology services in conjunction with standard and cutting edge infectious disease detection and identification technologies. Our signature services include microscopy for visual identification and quantification of a wide range of blood-borne pathogens, co-infection serology, biofilm detection, and genus wide molecular detection technology with sequencing for individualized species and/or strain identification. We participate in both CAP and API quality control programs and provide worldwide testing service.
Diseases of Interest: Chronic Fatigue Syndrome, Fibromyalgia, Gulf War Veterans Illness, Chronic Lyme Disease, ALS (Lou Gehrig’s Disease), Parkinson’s Disease, Multiple Sclerosis, Autism, Lupus, Ulcerative Colitis, Scleroderma, Rheumatoid Arthritis, Osteoarthritis, Crohn’s Disease.
Infections of Interest: Borrelia (Lyme), Babesia, Bartonella, Anaplasma, Ehrlichia, Q-Fever (Coxiella), Toxoplasma, Rickettsia, Plasmodium, XMRV
Important: This post is not a substitute for medical advise or treatment and is for informational purposes only. Please consult with a physician before starting any nutritional or biofilm protocol on your own.