Two controlled trials of antibiotic treatment in patients with persistent symptoms and a history of Lyme disease.

  title={Two controlled trials of antibiotic treatment in patients with persistent symptoms and a history of Lyme disease.},
  author={Mark S. Klempner and L T Hu and J. Evans and Christopher H. Schmid and George Magnus Johnson and Richard P Trevino and Dylan Norton and Laurence Levy and Donna S Wall and Jonathan McCall and Mark Kosinski and Arthur Weinstein},
  journal={The New England journal of medicine},
  volume={345 2},
BACKGROUND It is controversial whether prolonged antibiotic treatment is effective for patients in whom symptoms persist after the recommended antibiotic treatment for acute Lyme disease. METHODS We conducted two randomized trials: one in 78 patients who were seropositive for IgG antibodies to Borrelia burgdorferi at the time of enrollment and the other in 51 patients who were seronegative. The patients received either intravenous ceftriaxone, 2 g daily for 30 days, followed by oral… 

Benefit of intravenous antibiotic therapy in patients referred for treatment of neurologic Lyme disease

Prolonged intravenous antibiotic therapy is associated with improved cognition, fatigue, and myalgias in patients referred for treatment of neurologic Lyme disease and may be necessary to obtain symptomatic improvement in these patients.

Controlled trials of antibiotic treatment in patients with post-treatment chronic Lyme disease.

  • M. Klempner
  • Medicine
    Vector borne and zoonotic diseases
  • 2002
This paper will describe this patient population in detail and will review the clinical, microbiological, and selected biochemical and immunologic parameters and their responses to antibiotic treatment in the setting of a controlled trial.

Randomized Trial of Longer-Term Therapy for Symptoms Attributed to Lyme Disease.

In patients with persistent symptoms attributed to Lyme disease, longer-term antibiotic treatment did not have additional beneficial effects on health-related quality of life beyond those with shorter-term treatment.

Cognitive function in post-treatment Lyme disease Do additional antibiotics help?

Patients with post-treatment chronic Lyme disease who have symptoms but show no evidence of persisting Borrelia infection do not show objective evidence of cognitive impairment, and additional antibiotic therapy was not more beneficial than administering placebo.

A randomized, placebo-controlled trial of repeated IV antibiotic therapy for Lyme encephalopathy

I ceftriaxone therapy results in short-term cognitive improvement for patients with posttreatment Lyme encephalopathy, but relapse in cognition occurs after the antibiotic is discontinued, and treatment strategies that result in sustained cognitive improvement are needed.

Duration of Antibiotic Therapy for Early Lyme Disease

Oral doxycycline alone for 10 days is sufficient treatment for patients with early Lyme disease that manifests as erythema migrans, and the outcome of therapy might be enhanced by treatment with a parenteral agent such as ceftriaxone, which readily crosses the bloodbrain barrier.

Pre-treatment and post-treatment assessment of the C6 test in patients with persistent symptoms and a history of Lyme borreliosis

Antibodies to C6 persisted in patients with post-treatment Lyme disease syndrome following treatment, albeit at a markedly lower prevalence and titer than in untreated patients with acute disseminated Lyme disease.

Study and treatment of post Lyme disease (STOP-LD)

Ceftriaxone therapy in patients with PLS with severe fatigue was associated with an improvement in fatigue but not with cognitive function or an experimental laboratory measure of infection in this study.

Duration of antibiotic treatment in disseminated Lyme borreliosis: a double-blind, randomized, placebo-controlled, multicenter clinical study

The results indicate that oral adjunct antibiotics are not justified in the treatment of patients with disseminated LB who initially receive intravenous CRO for 3 weeks and 12 months after the end of intravenous antibiotic therapy, the levels of antibodies against Borrelia burgdorferi were markedly decreased in 50% of the patients with definite LB in both groups.



Tetracycline therapy for chronic Lyme disease.

  • S. Donta
  • Medicine, Psychology
    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
  • 1997
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.

Clinical and neurocognitive features of the post Lyme syndrome.

Despite antibiotic treatment, a sequelae of Lyme disease may be a PLS characterized by persistent arthralgia, fatigue, and neurocognitive impairment that is probably induced by Lyme disease.

Minocycline in Rheumatoid Arthritis: A 48-Week, Double-Blind, Placebo-Controlled Trial

A 48-week, randomized, double-blind, multicenter trial to determine the efficacy and safety of minocycline in treating rheumatoid arthritis when it is added to background NSAIDs or low-dose prednisone therapy in patients not receiving concomitant disease-modifying antirheumatic drugs.

A proposal for the reliable culture ofBorrelia burgdorferi from patients with chronic lyme disease, even from those previously aggressively treated

A new method for culturings B. burgdorferi from the blood of patients with chronic Lyme disease certainly defines the nature of the illness and establishes that it is of chronic infectious etiology, and should help to reestablish the gold standard in laboratory diagnosis of Lyme disease.

Evaluation of the intrathecal antibody response to Borrelia burgdorferi as a diagnostic test for Lyme neuroborreliosis.

Intrathecal antibody determinations are the most specific diagnostic test currently available for Lyme neuroborreliosis, but local antibody production in CSF is an inconsistent finding in American patients with late neurologic manifestations of the disorder.

The Fibromyalgia Impact Questionnaire: a useful tool in evaluating patients with post-Lyme disease syndrome.

The results of this study suggest that the modified FIQ may be a useful tool in evaluating PLDS patients and suggest that there may be some differences in the etiopathology of the symptoms experienced by PLDS and FM patients.

Group treatment of fibromyalgia: a 6 month outpatient program.

The group treatment of patients with FM in an outpatient setting shows promise; a more formal controlled study is needed to confirm this impression.

Practice guidelines for the treatment of Lyme disease. The Infectious Diseases Society of America.

  • G. WormserR. Nadelman B. Luft
  • Medicine
    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
  • 2000
This paper presents a meta-modelling study of the immune system’s response to Lyme Disease, which highlights the need to understand more fully the immune response to tick-borne infections.

Detection of Borrelia burgdorferi DNA by polymerase chain reaction in cerebrospinal fluid in Lyme neuroborreliosis.

PCR testing can sometimes detect B. burgdorferi DNA in CSF in patients with acute or chronic neuroborreliosis, but with current methods, the sensitivity of the test is limited.