Successful treatment of neuroborreliosis with ten day regimens

Thorstrand, Carita; Belfrage, Erik; Bennet, Rutger; Malmborg, Petter; Eriksson, Margareta

doi:10.1097/00006454-200212000-00011

Cited by 47 publications

(33 citation statements)

References 25 publications

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“…In a Swedish study, 203 children with Lyme neuroborreliosis were treated IV with penicillin (53 children), ceftriaxone (109 children), or cefotaxime (19 children) or orally with doxycycline (22 children). 35 At follow-up, symptoms and signs resolved in 58% of the children by the end of treatment, in 92% by 2 months and in all children by 6 months after treatment (three were lost to follow-up). In a retrospective Austrian study of 160 children with Lyme disease (45 [28%] with meningitis, facial palsy, or both 33 ), 33 received ceftriaxone IV, 7 received benzylpenicillin IM, and 5 received doxycycline orally.…”

mentioning

confidence: 90%

“…At least 10 studies have addressed the outcomes of treating neuroborreliosis with doxycycline. 12,14,15,[19][20][21][22]27,[33][34][35] All but two 14,34 used oral doxycycline; since blood levels achieved are comparable whether this drug is given orally or IV, data from these studies of IV doxycycline have been included. All studies were performed in Europe; most patients underwent CSF examination and were shown to have a CSF pleocytosis.…”

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confidence: 99%

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Practice Parameter: Treatment of nervous system Lyme disease (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology [RETIRED]

Halperin¹,

Shapiro²,

Logigian³

et al. 2007

Neurology

303

142

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Objective: To provide evidence-based recommendations on the treatment of nervous system Lyme disease and post-Lyme syndrome. Three questions were addressed: 1) Which antimicrobial agents are effective? 2) Are different regimens preferred for different manifestations of nervous system Lyme disease? 3) What duration of therapy is needed? Methods: The authors analyzed published studies ) using a structured review process to classify the evidence related to the questions posed. Results: The panel reviewed 353 abstracts which yielded 112 potentially relevant articles that were reviewed, from which 37 articles were identified that were included in the analysis. Conclusions:There are sufficient data to conclude that, in both adults and children, this nervous system infection responds well to penicillin, ceftriaxone, cefotaxime, and doxycycline (Level B recommendation). Although most studies have used parenteral regimens for neuroborreliosis, several European studies support use of oral doxycycline in adults with meningitis, cranial neuritis, and radiculitis (Level B), reserving parenteral regimens for patients with parenchymal CNS involvement, other severe neurologic symptomatology, or failure to respond to oral regimens. The number of children (Ն8 years of age) enrolled in rigorous studies of oral vs parenteral regimens has been smaller, making conclusions less statistically compelling. However, all available data indicate results are comparable to those observed in adults. In contrast, there is no compelling evidence that prolonged treatment with antibiotics has any beneficial effect in post-Lyme syndrome (Level A). NEUROLOGY 2007;69:91-102

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confidence: 90%

mentioning

confidence: 99%

Practice Parameter: Treatment of nervous system Lyme disease (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology [RETIRED]

Halperin¹,

Shapiro²,

Logigian³

et al. 2007

Neurology

303

142

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“…The appearance of post-Lyme disease symptoms seems to correlate with disseminated disease, a greater severity of illness at presentation, and delayed antibiotic therapy [12,[29][30][31][32][33]; but not with the duration of the initial antibiotic therapy [13,23]. Children appear to be less likely to develop post-Lyme disease symptoms [34][35][36][37][38][39][40][41][42].…”

Section: Post-lyme Disease Syndromementioning

confidence: 99%

Chronic Lyme Disease: A Review

Marques

2008

Infectious Disease Clinics of North America

177

123

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“…Pediatric population should be treated with the same drug options and timing of the adults [23], although a Swedish study involving 203 children with early neuroborreliosis has reported good results with shorter therapies (10 days) based on intravenous beta-lactam antibiotics or oral doxycycline (contraindicated in children less than 8 years) [32].…”

Section: Early Neuroborreliosis (Meningitis and Other Neurological Mamentioning

confidence: 99%

Therapy of Lyme Disease

Trevisan¹,

Errichetti²,

Meo³

et al. 2016

TODJ

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Borrelia burgdorferi is highly susceptible to antibiotic treatment and the majority of patients profit from this treatment. Antibiotic selection, dose and route of administration, and duration of therapy for Lyme disease depend on the patient's clinical manifestations and stage of disease, age, pregnancy status, as well as the presence of other concomitant diseases and/or allergies. Despite an appropriate antibiotic therapy, about 10-20% of patients may show persistent or recurrent symptoms ("post-treatment Lyme disease syndrome").In the present paper we will briefly discuss the post-exposure prophylaxis, before going on to talk over the current therapeutic approach regarding the management of Lyme disease according to the stage of disease/clinical manifestations. Finally, we will discuss the main treatment-related phenomenon, the Jarisch-Herxheimer reaction, and the treatment modalities for special categories of patients, namely pregnant women, subjects suffering from post-treatment Lyme disease syndrome, possible Borrelia-associated skin manifestations, coinfections and Baggio-Yoshinary syndrome.

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Successful treatment of neuroborreliosis with ten day regimens

Abstract: The prognosis of neuroborreliosis in children 2 months after treatment seems to be excellent with 10-day treatment regimens.

Cited by 47 publications

References 25 publications

Practice Parameter: Treatment of nervous system Lyme disease (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology [RETIRED]

Practice Parameter: Treatment of nervous system Lyme disease (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology [RETIRED]

Chronic Lyme Disease: A Review

Therapy of Lyme Disease

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