Where a doctor suspects neurological symptoms of Lyme disease they are recommended to carry out a neurological evaluation, including a lumbar puncture procedure in order to ensure appropriate treatment is given. Neurological symptoms of late-stage Lyme disease are considered more common in Europe but may be missed if a patient has a co-morbidity such as anxiety, depression, or a condition such as fibromyalgia or chronic fatigue syndrome. Patients with Lyme arthritis and objective evidence of neurological complications of Lyme disease are prescribed intravenous ceftriaxone. Alternatives include parenteral penicillin G, although the long-acting benzathine penicillin is not recommended as it does not achieve an effective concentration in the blood. Children are also treated with intravenous ceftriaxone or cefotaxime, with penicillin G remaining the alternative treatment method.
Further guidance on treatment of Lyme arthritis includes additional antibiotic therapy should the initial therapy fail to achieve results. Another four-week course of oral antibiotics or a two to four week course of intravenous ceftriaxone is suggested in cases of persistent or recurrent joint swelling in Lyme disease. However, inflammation can take several months to fully resolve following treatment so caution is recommended before any repeated treatment with antibiotics occurs. In the event that a second course of antibiotics fails to resolve the condition, patients will usually be prescribed medications such as non-steroidal anti-inflammatories (NSAIDs) for symptomatic relief. Intra-articular steroids may also be recommended but early symptoms of arthritis in Lyme disease usually contraindicate steroid use as this can leave the patient more vulnerable to the spread of infection. In severe and debilitating cases of synovitis (joint swelling), an arthroscopic synovectomy (the complete of partial removal of the synovial membrane) can help alleviate the inflammatory state.
Late Stage Lyme Disease Antibiotic – Neuroborreliosis
Patients suffering from late stage Lyme disease may have neuroborreliosis where the central, and/or the peripheral nervous system, is involved. Treatment for neuroborreliosis is usually ceftriaxone intravenously at a dose of 2grams per day for two to four weeks. Alternatively, intravenous cefotaxime or penicillin G may be prescribed. Patients should be aware that treatment of neuroborreliosis will likely take a slow course and that complete recovery may not occur. Repeated treatment is not recommended however, unless a patient has objective signs of a relapse. Children with neuroborreliosis are also treated with ceftriaxone with cefotaxime or penicillin G as alternatives.
Chronic Lyme Disease Antibiotic Treatment
Diagnosis with chronic Lyme disease is not generally recognised and, as such, no precise treatment guidelines are given. Sometimes referred to as post-Lyme disease syndrome, patients may have symptoms such as arthralgia, myalgia, fatigue, or some degree of cognitive impairment. European cases appear to be less common (or less commonly reported, perhaps) than in North America but this subset of patients may experience residual symptoms for weeks, months, or even years after treatment for Lyme disease. Such symptoms can also occur following other diseases and it is thought that around 10% of people with no reported medical condition suffer from fatigue or arthralgias.
In the majority of cases however, the official IDSA stance is that there is “insufficient evidence to regard ‘chronic Lyme disease’ as a separate diagnostic entity”, meaning that repeated or long-term oral or intravenous antibiotics are not recommended.
Patients looking to self-conferred Lyme Literate Medical Doctors (LLMDs) for a diagnosis and treatment referral should be wary of the politics surrounding Lyme disease and ensure that their physician is behaving responsibly. Whilst most will simply be trying to help patients as best they can some, as with any profession, practice unscrupulous methods for acquiring money, power, and recognition and a patient with a chronic medical condition, whatever its cause, is often seen as vulnerable. The use of any Lyme disease antibiotic requires careful consideration and a second opinion should be sought should a patient feel uncomfortable with their current physician.
Continue Reading –> Dangers of Long-Term Lyme Disease Antibiotic Treatment