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Counterpoint: Long-Term Antibiotic Therapy Improves Persistent Symptoms Associated with Lyme Disease - Source: Clinical Infectious Diseases, July 15, 2007

  [ 427 votes ]   [ 6 Comments ]
By Raphael B. Stricker, MD • www.ProHealth.com • September 13, 2007


[Full text of this article is available at the International Lyme and Associated Diseases Society website.] Background: Controversy exists regarding the diagnosis and treatment of Lyme disease. Patients with persistent symptoms after standard (2–4-week) antibiotic therapy for this tickborne illness have been denied further antibiotic treatment as a result of the perception that long-term infection with the Lyme spirochete, Borrelia burgdorferi, and associated tickborne pathogens is rare or nonexistent.

Methods: I review the pathophysiology of B. burgdorferi infection and the peer-reviewed literature on diagnostic Lyme disease testing, standard treatment results, and coinfection with tickborne agents, such as Babesia, Anaplasma, Ehrlichia, and Bartonella species. I also examine uncontrolled and controlled trials of prolonged antibiotic therapy in patients with persistent symptoms of Lyme disease.

Results: The complex “stealth” pathology of B. burgdorferi allows the spirochete to invade diverse tissues, elude the immune response, and establish long-term infection. Commercial testing for Lyme disease is highly specific but relatively insensitive, especially during the later stages of disease. Numerous studies have documented the failure of standard antibiotic therapy in patients with Lyme disease. Previous uncontrolled trials and recent placebo controlled trials suggest that prolonged antibiotic therapy (duration, 14 weeks) may be beneficial for patients with persistent Lyme disease symptoms. Tickborne coinfections may increase the severity and duration of infection with B. burgdorferi.

Conclusions: Prolonged antibiotic therapy may be useful and justifiable in patients with persistent symptoms of Lyme disease and coinfection with tickborne agents.

Source: Clinical Infectious Diseases. 2007:45 (15 July), pp. 149-157. PMID: 17578772, by Stricker RB. International Lyme and Associated Diseases Society, Bethesda, Maryland, USA. [E-mail rstricker@usmamed.com ]. From a paper presented at the 44th Annual Meeting of the Infectious Diseases Society of America, Toronto, Canada, October 2006.

(This article is a "counterpoint" to another article in the same issue by PG Auwaerter, on pages 143-8.)





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Article Comments Post a Comment

Thanks for Posting!
Posted by: aniek
Sep 13, 2007
Thank you for posting this article! Especially after the recent article posted with the neurological guidelines.
Reply Reply

Stricker counterpoint
Posted by: tennis2764
Sep 13, 2007
Awesome article he is right on long term antibiotic works for most people. great stuff here
Reply Reply

Thank you!
Posted by: mollystwin
Sep 14, 2007
Thank you so much for posting this side of Lyme treatment. It is so important for people with lyme to understand that this treatment is being used and is WORKING for many who suffer from this disease. I personally have experienced the benefits from this treatment along with many friends and family members.
Reply Reply

Good Choice
Posted by: Itsy_bitsyone
Sep 14, 2007
Thank you for understanding that there are two standards of care and that both sides should be posted, in all fairness. Thanks for listenning and doing the right thing.
Reply Reply

Thank You
Posted by: chrlstlna
Sep 14, 2007
Thank you ImmuneSupport for being balanced :) If only all journalistic outlets could be so fair. Again, Thank You from the bottom of my heart.
Reply Reply


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