Lyme Disease treatment is fairly simple in the majority of cases caught early enough with treatment of Lyme disease mainly consisting of short-course antibiotics. However, poor recognition of the disease, problems with misdiagnosis, and difficulties with Lyme disease tests can all delay treatment and allow the infection to become more widely disseminated. Lyme disease treatment at this stage is more difficult and severe damage may have been incurred by the joints, nervous system, the heart, or other organ or system requiring additional therapy to repair such damage. Other factors will also influence the treatment of a patient for Lyme disease, such as their age, their symptoms, whether they are pregnant or trying to become pregnant, any other medical conditions, allergies, or previous problems with antibiotics, and also the time since they became infected.
Lyme Disease Antibiotic Treatment
Antibiotics are the mainstay of Lyme disease treatment with oral antibiotics most regularly used and doxycycline the preferred option for most patients. The use of doxycycline is favored due to its effectiveness at treating many other tick-borne diseases that may have been transmitted along with the Borrelia bacteria (they do not address Babesiois however). Contraindications for treatment with doxycycline include those under the age of nine, pregnant women or those breastfeeding, and those with an allergy to this form of antibiotic. Young children and a developing foetus can suffer from permanent teeth-staining if they, or their mothers, take doxycycline. Cefuroxime axetil (Ceftin) may be used instead for early Lyme disease cases, and this antibiotic was approved in 1996 by the FDA for the condition. Amoxicillin, penicillin, and erythromycin are also available although many patients experience unpleasant side-effects from the latter, such as short-term gastrointestinal problems. Some patients report side-effects from antibiotic treatment which have been attributed to a Jarisch-herxheimer reaction. Colloquially known as ‘herxing’, this is thought due to the release of toxins as a defensive strategy as the spirochaetes are attacked during treatment. Further research on the pathogenicitiy of Borrelia bacteria may call this into question however, with ramifications for those patients who are told that they must feel worse to feel better.
Lyme Disease Treatment for Children
Amoxicillin is primarily used for children with Lyme disease, and erythromycin for pregnant patients with the condition. Spirochaetal diseases do present risks for pregnancy when left untreated and appropriate use of antibiotics is warranted in Lyme disease patients. Erythromycin is less effective against the bacterial infection but is not thought to pose a risk to the unborn baby; treatment may take slightly longer than with doxycyline used in non-pregnant patients. Lyme disease treatment with antibiotics usually lasts between ten and twenty-eight days and long-term antibiotic therapy is advised against by most medical authorities despite its use by some doctors. Long term intravenous antibiotic therapy has similarly been shown as inappropriate in almost all cases of Lyme disease and can pose significant risks to a patient (Marques, 2008).
Lyme Disease Treatment Study
A comprehensive randomized, placebo-controlled, double-blind study of patients with Lyme borreliosis conducted by Oksi, et al (2007), found that long-term oral antibiotic therapy (amoxicillin) following three weeks of ceftriaxone treatment had no discernible benefit in cases of Lyme disease compared to placebo. The researchers also observed that it is unhelpful to assess clinical outcome immediately after treatment and that judgements should be made instead six to twelve months after antibiotic treatment. Levels of antibodies to Borrelia burgdorferi were markedly decreased in around half of the patients in both placebo and treatment groups twelve months after they both received initial ceftriaxone treatment. Those patients with persistent high antibody levels were found in equal numbers in both the control and the treatment group and such findings were judged as unhelpful in determining case progression for patients following antibiotic treatment.
Prognosis for patients was excellent following three weeks ceftriaxone treatment with 78.6% of patients having an excellent or good outcome on the visual analogue scale. Just 11.7% of patients had a poor outcome, which may have been for a number of reasons, such as initial misdiagnosis. This is further supported by the researchers, Oski, et al (2007), clarification of patients as having either definite Lyme Borreliosis, or possible Lyme disease. In the former group the excellent or good outcome rate rose to 92.5% with just 5.7% (three patients) having a poor outcome. Patients who do not respond well to antibiotic treatment may have complications due to delay in diagnosis or other existing medical issues that compound the problem of Lyme disease. Late stage Lyme disease may mean that the bacteria have disseminated throughout the body to the degree where they have crossed the blood-brain barrier. This can make treatment of Lyme disease difficult as most antibiotics cannot cross this barrier. Minocycline is usually used in such cases following at least four weeks of oral or intravenous ceftriaxone.