Treatment of Late Lyme Borreliosis—randomised Comparison of Ceftriaxone and Penicillin

Dattwyler, Raymond J.; Volkman, David J.; Halperin, John J.; Luft, Benjamin J.

doi:10.1016/s0140-6736(88)92011-9

Cited by 299 publications

(129 citation statements)

References 21 publications

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“…Patients with late manifestations can have a slower response to therapy, sometimes taking weeks or months to recover [15][16][17][18][19][20][21][22][23]. Some patients may have incomplete resolution due to irreversible damage, as can occur in facial nerve palsy with residual facial weakness.…”

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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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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“…(Steere, 2001;Steere et al, 1987) In most patients, the arthritis can be treated successfully with either a 1 or 2-month course of oral doxycycline or a 2 or 4-week course of intravenous (IV) ceftriaxone. (Dattwyler et al, 1988;Steere et al, 1994) In rare cases however, synovitis persists for months or even several years despite treatment with ≥2 months of oral antibiotics, ≥1 months of IV antibiotics, or usually both. (Steere and Angelis, 2006;Steere et al, 1994) Since PCR results for Bb DNA in joint fluid are almost always negative in the post-antibiotic period (Carlson et al, 1999;Nocton et al, 1994;Steere and Angelis, 2006) and since cellular and humoral immune responses to Bb antigens begin to decline soon after antibiotic treatment (Kannian et al, 2007a;Kannian et al, 2007b), antibiotic therapy appears to result in the nearly complete or total eradication of spirochetes from the joint, yet synovial inflammation still persists.…”

Section: Introductionmentioning

confidence: 99%

Searching for borrelial T cell epitopes associated with antibiotic-refractory Lyme arthritis

Drouin

Glickstein

Kwok

et al. 2008

Molecular Immunology

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Antibiotic-refractory Lyme arthritis is believed to result from an infection-induced autoimmune response triggered by the spirochete Borrelia burgdorferi (Bb). Disease susceptibility is associated with the HLA alleles DRB1*0101, 0401, 0402, 0404, 0405 and DRB5*0101, and all these MHC molecules bind the Bb epitope OspA 163-175 . However, not all patients have a proliferative response to this epitope. To identify other possible Bb epitopes involved in this disease process, the algorithm TEPITOPE was used to scan 17 immunogenetic Bb proteins for potential T cell epitopes with a refractory arthritis-associated MHC binding profile, and the Bb proteome was searched for peptides with sequence homology to OspA [165][166][167][168][169][170][171][172][173] . Sixteen promising T epitopes were identified and their MHC binding profiles to 13 MHC molecules were verified using in vitro MHC/peptide binding assays. One peptide, BBK32 392-404 , had a strong refractory-arthritis associated MHC binding profile, and another GK 297-306 shared sequence homology to OspA [165][166][167][168][169][170][171][172][173] . However, patient cells did not proliferate in response to either peptide making it highly unlikely they were involved in a refractory course. A comparison of the in silico and in vitro results revealed that TEPITOPE correctly predicted 74% of the in vitro binding peptides, but it incorrectly predicted that 44% of the in vitrononbinding peptides would bind. For a particular MHC molecule, concordance between the in silico and in vitro results varied anywhere between 33% and 100%. Therefore, while additional Bb epitopes may be involved in the development of antibiotic-refractory Lyme arthritis, recognition of OspA [163][164][165][166][167][168][169][170][171][172][173][174][175] remains the only known Bb epitope associated with this disease.

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“…According to some studies, in most cases 2 weeks of intravenous therapy with ceftriaxone is enough for resolving the illness [45,46]. Compared with penicillin, the advantages of ceftriaxone are its excellent cerebro-spinal fluid penetration and long serum half-life, which permits once-per-day dosing.…”

Section: Arthritismentioning

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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Treatment of Late Lyme Borreliosis—randomised Comparison of Ceftriaxone and Penicillin

Cited by 299 publications

References 21 publications

Chronic Lyme Disease: A Review

Chronic Lyme Disease: A Review

Searching for borrelial T cell epitopes associated with antibiotic-refractory Lyme arthritis

Therapy of Lyme Disease

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