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

@article{Klempner2001TwoCT,
  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},
  year={2001},
  volume={345 2},
  pages={
          85-92
        }
}
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.

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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.

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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.

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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.

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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.
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