A comparison of two treatment regimens of ceftriaxone in late Lyme disease

Dattwyler, Raymond J.; Wormser, Gary P.; Rush, Thomas J.; Finkel, Michael F.; Schoen, Robert T.; Grunwaldt, Edgar; Franklin, Michael; Hilton, Eileen; Bryant, Gary L.; Agger, William A.; Maladorno, D.

doi:10.1007/s00508-005-0361-8

Cited by 81 publications

(57 citation statements)

References 15 publications

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“…Patients with late manifestations can have a slower response to therapy, sometimes taking weeks or months to recover [15][16][17][18][19][20][21][22][23]. Some patients may have incomplete resolution due to irreversible damage, as can occur in facial nerve palsy with residual facial weakness.…”

Section: Post-lyme Disease Syndromementioning

confidence: 99%

Chronic Lyme Disease: A Review

Marques

2008

Infectious Disease Clinics of North America

175

123

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Section: Post-lyme Disease Syndromementioning

confidence: 99%

Chronic Lyme Disease: A Review

Marques

2008

Infectious Disease Clinics of North America

175

123

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“…This joint infection can usually be treated successfully with a 1-mo course of oral antibiotic therapy (3) or a 2-to 4-wk course of i.v. ceftriaxone (4), and the arthritis resolves (termed antibiotic-responsive arthritis). However, in rare cases patients have persistent arthritis despite treatment with Ն 2 mo of oral antibiotics, Ն 1 mo of i.v.…”

mentioning

confidence: 99%

Decline in the Frequencies of Borrelia burgdorferi OspA161–175-Specific T Cells after Antibiotic Therapy in HLA-DRB1*0401-Positive Patients with Antibiotic-Responsive or Antibiotic-Refractory Lyme Arthritis

Kannian

Drouin

Glickstein

et al. 2007

The Journal of Immunology

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Synovitis in patients with antibiotic-refractory Lyme arthritis persists for months to several years after antibiotic therapy. This course, which may result from infection-induced autoimmunity, is associated with T cell recognition of Borrelia burgdorferi outer surface protein A (OspA161–175) and with HLA-DR molecules that bind this epitope, including the DRB1*0401 molecule. In this study, we used tetramer reagents to determine the frequencies of OspA161–175-specific T cells in samples of PBMC and synovial fluid mononuclear cells (SFMC) from 13 DRB1*0401-positive patients with antibiotic-responsive or antibiotic-refractory arthritis. Initially, three of the six patients (50%) with antibiotic-responsive arthritis and four of the seven patients (57%) with antibiotic-refractory arthritis had frequencies of OspA161–175-specific CD4+ T cells in peripheral blood above the cutoff value of 4 per 105 cells. Among the five patients with concomitant PBMC and SFMC, four (80%) had OspA tetramer-positive cells at both sites, but the mean frequency of such cells was 16 times higher in SFMC, reaching levels as high as 1,177 per 105 cells. In the two patients in each patient group in whom serial samples were available, the frequencies of OspA161–175-specific T cells declined to low or undetectable levels during or soon after antibiotic therapy, months before the resolution of synovitis in the two patients with antibiotic-refractory arthritis. Thus, the majority of patients with Lyme arthritis initially have increased frequencies of OspA161–175-specific T cells. However, the marked decline in the frequency of such cells with antibiotic therapy suggests that persistent synovitis in the refractory group is not perpetuated by these cells.

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“…According to some studies, in most cases 2 weeks of intravenous therapy with ceftriaxone is enough for resolving the illness [45,46]. Compared with penicillin, the advantages of ceftriaxone are its excellent cerebro-spinal fluid penetration and long serum half-life, which permits once-per-day dosing.…”

Section: Arthritismentioning

confidence: 99%

Therapy of Lyme Disease

Trevisan¹,

Errichetti²,

Meo³

et al. 2016

TODJ

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Borrelia burgdorferi is highly susceptible to antibiotic treatment and the majority of patients profit from this treatment. Antibiotic selection, dose and route of administration, and duration of therapy for Lyme disease depend on the patient's clinical manifestations and stage of disease, age, pregnancy status, as well as the presence of other concomitant diseases and/or allergies. Despite an appropriate antibiotic therapy, about 10-20% of patients may show persistent or recurrent symptoms ("post-treatment Lyme disease syndrome").In the present paper we will briefly discuss the post-exposure prophylaxis, before going on to talk over the current therapeutic approach regarding the management of Lyme disease according to the stage of disease/clinical manifestations. Finally, we will discuss the main treatment-related phenomenon, the Jarisch-Herxheimer reaction, and the treatment modalities for special categories of patients, namely pregnant women, subjects suffering from post-treatment Lyme disease syndrome, possible Borrelia-associated skin manifestations, coinfections and Baggio-Yoshinary syndrome.

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A comparison of two treatment regimens of ceftriaxone in late Lyme disease

Cited by 81 publications

References 15 publications

Chronic Lyme Disease: A Review

Chronic Lyme Disease: A Review

Decline in the Frequencies of Borrelia burgdorferi OspA161–175-Specific T Cells after Antibiotic Therapy in HLA-DRB1*0401-Positive Patients with Antibiotic-Responsive or Antibiotic-Refractory Lyme Arthritis

Therapy of Lyme Disease

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