When there are good reasons for suspecting
Lyme borreliosis, treatment with an antibiotic is mandatory. If the clinical picture clearly shows erythema migrans, antibiotic treatment must be instituted also in the absence of a bacteriological diagnosis. Later manifestations require longer and higher-dose antibiotic treatment. Except acrodermatitis stage II and III manifestations should be treated intravenously. The success of treatment cannot be monitored serologically. A European vaccine is currently being developed.