Tetracycline Therapy for Chronic Lyme Disease

Abstract

Two hundred seventy-seven patients with chronic Lyme disease were treated with tetracycline for 1 to 11 months (mean, 4 months); the outcomes for these patients were generally good. Overall, 20% of the patients were cured; 70% of the patients' conditions improved, and treatment failed for 10% of the patients. Improvement frequently did not take place for several weeks; after 2 months of treatment, 33% of the patients' conditions were significantly improved (degree of improvement, 75%-100%), and after 3 months of treatment, 61% of the patients' conditions were significantly improved. Treatment outcomes for seronegative patients (20% of all patients) were similar to those for seropositive patients. Western immunoblotting showed reactions to one or more Borrelia burgdorferi-specific proteins for 65% of the patients for whom enzyme-linked immunosorbent assays were negative. Whereas age, sex, and prior erythema migrans were not correlated with better or worse treatment outcomes, a history of longer duration of symptoms or antibiotic treatment was associated with longer treatment times to achieve improvement and cure. These results support the use of longer courses of treatment in the management of patients with chronic Lyme disease. Controlled trials need to be conducted to validate these observations.

Chronic Lyme Disease: A Review

“…Three of these randomized trials have been criticized as offering "too little, too late" [68][69][70], based on retrospective, open-label case-series that suggested a possible role of prolonged antibiotic therapy in patients diagnosed with "chronic Lyme disease" [71,72]. In general, caseseries studies are fraught with potential for biases.…”

Advancement in Borrelia burgdorferi Antibody Testing: Comparative Immunoblot Assay (COMPASS)

“…For example, 10 days versus 30 days (Stanek & Strle, 2003) doxycyclin treatment were also suggested. Moreover we found a study applying 11 months long treatment (Donta, 1997). In contrast, azithromycin described to be effective in a five day course (Arnez et al, 2002, Hunfeld et al, 2005.…”

Clinical Manifestations and Treatment of Lyme Disease

“…[34][35][36] These limitations include using loose case definitions for post-Lyme disease syndrome and interpretation of Lyme disease diagnostic testing criteria that is not consistent with the current recommendations by the Centers for Disease Control and Prevention. In addition, controlled trials found that up to 40% of subjects with post-Lyme disease syndrome report a positive response to placebo.…”