Randomized controlled trials have ascertained the efficiency of antibiotics in treating erythema migrans, the hallmark of early stage
Lyme borreliosis. Oral amoxicillin and doxycycline are first-line treatment options, though phenoxymethylpenicillin, cefuroxime axetil and azithromycin are alternative second-line options. Treatments for secondary and tertiary
Lyme borreliosis are more poorly documented, and antibiotics are not always effective. This is due to the unique pathophysiology of late
Lyme borreliosis, which involves not only bacterial infection, but also immunological response. Since there is no completely reliable method of diagnosis, it is difficult to choose the proper treatment and to evaluate treatment efficacy. However, numerous studies have shown that ceftriaxone and doxycycline are the 2 most efficient antibiotics, particularly in
Lyme arthritis and in neuroborreliosis. In late
Lyme borreliosis, these antibiotics are less efficient, and different treatment schemes with variations in dosage or duration did not produce convincing results.
Copyright 2009 S. Karger AG, Basel.