Doxycycline versus ceftriaxone for the treatment of patients with chronic Lyme borreliosis

Ogrinc, Katarina; Logar, Mateja; Lotrič‐Furlan, Stanka; Cerar, Daša; Ružić‐Sabljić, Eva; Strle, Franc

doi:10.1007/s00508-006-0698-7

Cited by 26 publications

(17 citation statements)

References 20 publications

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“…Doxycycline acts on the bacterial 30S ribosomal subunit (19), while ceftriaxone can generally be described as having beta-lactam activity (20). Although previous clinical studies showed that doxycycline can be as effective as third-generation cephalosporin antibiotics like ceftriaxone (21,22), recent in vitro work suggests that doxycycline may not be as effective as ceftriaxone against stationaryphase bacteria (23). Importantly, the role of immune responses to infection is integral to the treatment mode for microbiostatic an-tibiotics like doxycycline, such that results from in vitro studies should not be overinterpreted to the in vivo situation.…”

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confidence: 99%

Persister Development by Borrelia burgdorferi Populations In Vitro

Caskey

Embers

2015

Antimicrob Agents Chemother

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Doxycycline is an antibiotic commonly used to treat Lyme disease and other bacterial infections. The MIC and minimum bactericidal concentration (MBC) for Borrelia burgdorferi have been investigated by different groups but were experimentally established in this study as a function of input cell density. We demonstrated that B. burgdorferi treated in the stationary phase has a higher probability of regrowth following removal of antibiotic. In addition, we determined experimentally and mathematically that the spirochetes which persist posttreatment do not have a longer lag phase but exhibit a lower growth rate than untreated spirochetes. Finally, we found that treating the spirochetes by pulse-dosing did not eliminate growth or reduce the persister population in vitro. From these data, we propose that B. burgdorferi persister development is stochastic and driven by slowed growth.

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confidence: 99%

Persister Development by Borrelia burgdorferi Populations In Vitro

Caskey

Embers

2015

Antimicrob Agents Chemother

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“…The higher IgG in the 2 nd and 3 rd stages is consistent with the clinical signs, especially the cardiovascular ones, and is highly suggestive of borrelia-induced heart disease. The gradual decrease in the patient's antibodies may be due to a chronic subclinical phase of the disease, or to the normal dynamics of immunological recovery, as reported in human beings and other animals (Ogrinc et al, 2002;Kannian et al, 2007).…”

Section: Discussionmentioning

confidence: 85%

Cardiac manifestations of borreliosis in a dog: a case report

Agudelo¹,

Schánilec²,

Kybicová³

et al. 2011

Vet. Med. - Czech

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ABSTRACT:In Europe Lyme disease is caused by the spirochete Borrelia burgdorferi sensu lato. It presents with a variety of clinical manifestations including heart disease and problems of the nervous system, skin and joints. Lyme carditis occurs in 4-10% of infected humans and is characterized by a plethora of cardiovascular syndromes such as arrhythmia, myocarditis, and pericarditis among others. This article is a case report of a serologically positive (B. burgdorferi s.l.) dog, in which the antibody dynamics correlated with clinical, electrocardiographic, and echocardiographic findings of heart disease resembling human Lyme-induced dilated cardiomyopathy (DCM). Keywords: borreliosis; atrial fibrillation; serology; cardiomegaly; dogsList of abbreviations AF = atrial fibrillation; ALP = alkaline phosphatise; ANA test = antinuclear antibody test; AV = atrioventricular; BID = twice daily; CBC = complete blood count; CDCD-VFU = Clinic of Dog and Cat Diseases, University of Veterinary and Pharmaceutical Sciences, Brno; DCM = dilated cardiomyopathy; DNA = deoxyribonucleic acid; ECG = electrocardiography; IgG = Immunoglobulin G; IgM = Immunoglobulin M; PCR = polymerase chain reaction; SF = shortening fraction; SID = once daily; TBE = tick-borne encephalitis; TID = three times daily; VHS = vertebral scale size

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“…In a study by Lauhio and co-workers [23] it was shown that three month lymecycline has a favorable effect in acute chlamydia arthritis and recently it was demonstrated that six months combination therapy of two antibiotics is efficient in chronic chlamydia arthritis [24]. Single antibiotic therapy with doxycycline in disseminated LB has shown relatively low cure rates, as has been shown in studies by Borg and colleagues [25], Orgnic and coworkers [26] as well as by Ljøstad and co-workers [27]. Thus, one possibility to achieve better cure rates could be to use a combination therapy of doxycycline and intravenous ceftriaxone, at least to the subgroup of patients with persistent symptoms after ceftriaxone treatment.…”

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confidence: 88%

Serum Matrix Metalloproteinase-8 and -9 Levels in Disseminated Lyme Borreliosis with Special Reference to Arthritis

Lauhio¹,

Oksi²,

Tervahartiala³

et al. 2012

BIO

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Recent evidence suggests that matrix metalloproteinases (MMPs) are involved in pathogenesis of Lyme borreliosis (LB). We studied serum levels of MMP-8 and MMP-9 in disseminated LB patients with special reference to arthritis. Serum MMP-8 and-9 levels were analyzed by enzyme-linked immunoabsorbent assay from 110 patients from our previous multicenter, prospective study. Serum samples were taken before betalactam antibiotic treatment at study entry and after antibiotic treatment, at 1 year follow-up.Among disseminated LB patients (n = 110) mean (± SEM) serum MMP-8 and -9 levels (ng/ml) at study entry were statistically significantly higher than at 1 year follow-up (28.0 ± 1.9 versus 23.1 ± 1.6, P = 0.0313 and 398.0 ± 22.7 vs. 334.3 ± 23.6, P = 0.0219, respectively). Among Lyme arthritis (LA) patients (n = 34) at study entry serum MMP-8, but not MMP-9, levels decreased significantly when compared to serum levels of those at 1 year follow-up (35.7 ± 4.4 vs. 22.4 ± 2.3, P = 0.0093 and 398.6 ± 44.1 vs. 297.8 ± 40.3, P = 0.0505, respectively). The mean (± SEM) serum levels (ng/ml) of MMP-8 were significantly higher after betalactam antibiotic treatment at 1 year follow-up among antibiotic resistant LA patients with poor response than among those LA patients who were totally recovered (32.8 ± 6.4 vs. 20.1 ± 2.3, P = 0.0376). In contrast, the mean (± SEM) serum levels (ng/ml) of MMP-9 of antibiotic resistant LA patients showed no statistical significant difference when compared to those LA patients who were totally recovered at 1 year follow-up (297.8 ± 40.3 vs. 396.8 ± 93.9, P = 0.80).In conclusion, our results suggest that serum MMP-8 levels are excessively upregulated in disseminated LB contributing to inflammatory response, and related to persistent joint symptoms. This novel finding may offer in the future new laboratory possibilities to diagnose patients with persistent symptoms after betalactam antibiotic treatment. In addition the present findings suggest that to improve the outcome of disseminated borreliosis, the therapy of disseminated LB should include MMP-8 inhibitor such as doxycycline, possibly in combination therapy such as a combination of ceftriaxone and doxycycline. BIO © [2012], Copyright CCAAS Anneli Lauhio, et. al., BIO 2012, 2, 68-74 69 http://ccaasmag.org/BIO

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Doxycycline versus ceftriaxone for the treatment of patients with chronic Lyme borreliosis

Cited by 26 publications

References 20 publications

Persister Development by Borrelia burgdorferi Populations In Vitro

Persister Development by Borrelia burgdorferi Populations In Vitro

Cardiac manifestations of borreliosis in a dog: a case report

Serum Matrix Metalloproteinase-8 and -9 Levels in Disseminated Lyme Borreliosis with Special Reference to Arthritis

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