Abstract
There is much controversy about the treatment of Lyme disease with respect to 2 poorly
defined entities: “chronic Lyme disease” and “posttreatment Lyme disease syndrome.”
In the absence of direct evidence that these conditions are the result of a persistent
infection, some mistakenly advocate extended antibiotic therapy (≥6 months), which
can do great harm and has resulted in at least 1 death. The purpose of this brief
report is to review what is known from clinical research about these conditions to
assist both practicing physicians and lawmakers in making sound and safe decisions
with respect to treatment.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The American Journal of MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Two controlled trials of antibiotic treatment in patients with persistent symptoms and a history of Lyme disease.N Engl J Med. 2001; 345: 85-92
- Study and treatment of post Lyme disease (stop-LD): a randomized double-masked clinical trial.Neurology. 2003; 60: 1923-1930
- Death from inappropriate therapy for Lyme disease.Clin Infect Dis. 2000; 31: 1107-1109
- Gall bladder sludge: what is its clinical significance?.Curr Gastroenterol Rep. 2001; 3: 166-173
- Clostridium difficile-associated disease: an emerging threat to patient safety: insights from the Society of Infectious Diseases Pharmacists.Pharmacotherapy. 2006; 26: 299-311
- Antimicrobial resistance prevention initiative—an update: proceedings of an expert panel.Am J Med. 2007; 120: S4-S25
- Misconceptions about Lyme disease: confusions hiding behind ill-chosen terminology.Ann Intern Med. 2002; 136: 413-419
- Neuroprotection by tetracyclines.Trends Pharmacol Sci. 2004; 25: 609-612
- β-lactam antibiotics offer neuroprotection by increasing glutamate transporter expression.Nature. 2005; 433: 73-77
- Multiple neuroprotective mechanisms of minocycline in autoimmune CNS inflammation.Neurobiol Dis. 2007; 25: 514-525
- Gabapentin for the symptomatic treatment of chronic neuropathic pain in patients with late-stage Lyme borreliosis: a pilot study.Dermatology. 2005; 211: 123-127
- The clinical assessment, treatment, and prevention of Lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases Society of America.Clin Infect Dis. 2006; 43: 1089-1134
- Practice parameter: treatment of nervous system Lyme disease (an evidence-based review).Neurology. 2007; 69: 91-102
- A critical appraisal of “chronic Lyme disease.”.N Engl J Med. 2007; 357: 1422-1430
Article info
Identification
Copyright
© 2008 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
