| Prolonged antibiotics up to
100 days were successful in Europe. Wahlberg and colleagues
found “Short periods of treatment were not generally effective.”[1]
Longer courses up to 114 days were much more successful than
14 day courses, “The outcome was successful in four of
13 treatments with 14 days of intravenous ceftriaxone alone,
in 50 of 56 assessable treatments with ceftriaxone followed
by 100 days of amoxycillin plus probenecid, and in 19 of 23
completed treatments with ceftriaxone followed by 100 days of
cephadroxil.”[1] The success of prolonged therapy by the
Europeans was questioned by the IDSA [2] by the European’s
inclusion of the B. afzelli and B. garinii in the trials. Nevertheless,
similar successes of prolonged treatment has been reported at
professional meetings in the USA [3-5] with B. burgdorferi.
Reference
1.Logigian
EL, Kaplan RF, Steere AC. Successful treatment of Lyme encephalopathy
with intravenous ceftriaxone. J Infect Dis 1999 Aug;180(2):377-83.
2.Donta
ST. Tetracycline therapy for chronic Lyme disease. Clin Infect
Dis 1997 Jul;25 Suppl 1:S52-6.
3.
Wormser GP, Nadelman RB, Dattwyler RJ, Dennis DT, Shapiro ED,
Steere AC, Rush TJ, Rahn DW, Coyle PK, Persing DH, Fish D, Luft
BJ. Practice Guidelines for the Treatment of Lyme Disease Clinical
Infectious Diseases 2000;31:1-14.
4.
Fallon BA, Tager F, Keilp J, Weiss N, Liebowitz MR, Fein L,
Liegner K. Repeated Antibiotic Treatment in Chronic Lyme Disease.
Journal of Spirochetal and Tick-Borne Diseases 1999;6(4):94-102.
5.
Cameron DJ. 21st Century Lyme disease [presentation]. 14th International
Scientific Conference on Lyme Disease & Other Tick-Borne
Disorders. Farmington, Ct. April 2001.
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