A randomized, placebo-controlled trial of repeated IV antibiotic therapy for Lyme encephalopathy

Fallon, Brian A.; Keilp, John G.; Corbera, Kathy; Petkova, Eva; Britton, Carolyn B.; Dwyer, Edward M.; Slavov, I; Cheng, Jung‐Chien; Dobkin, Jay F.; Nelson, Douglas; Sackeïm, Harold A.

doi:10.1212/01.wnl.0000284604.61160.2d

Cited by 325 publications

(397 citation statements)

References 33 publications

(26 reference statements)

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“…Patients in Category 2 have other recognized diseases and have been misdiagnosed with Lyme disease. The distribution of patients who fall into these categories can be estimated by the difficulty in accruing patients into the placebo-controlled studies of antibiotic treatment in patients with post-Lyme disease syndrome (Category 4), where only 1 to 10% of the screened individuals were eligible [2][3][4].…”

Section: Chronic Lyme Diseasementioning

confidence: 99%

“…Recent studies showed little evidence of a substantial role of other tick-borne infections in the majority of patients with post-Lyme disease syndrome [4,[48][49][50]. There has been little research in the role of autoimmunity in post-Lyme disease syndrome, but one study showed no association between a class II allele or genotype [51].…”

Section: The Possible Causes Of Post-lyme Disease Symptomsmentioning

confidence: 99%

“…Objective evidence of Borrelia infection in patients with post-Lyme disease syndrome has not been found using PCR [4,49] or culture [4,49]. It should be noted however, that B. burgdorferi culture and PCR have low sensitivity in most body fluids from patients with Lyme disease [56,57].…”

Section: The Possible Causes Of Post-lyme Disease Symptomsmentioning

confidence: 99%

“…The fourth study enrolled patients with post-Lyme disease syndrome who were seropositive by IgG western blot, had objective memory impairment and had received at least 3 weeks of intravenous antibiotic therapy [4]. There were only 37 patients enrolled, and they were randomized 2:1 to receive 10 weeks of intravenous ceftriaxone (23 patients) or intravenous placebo (14 patients).…”

Section: Studies Of Antibiotic Treatment In Post-lyme Disease Syndromementioning

confidence: 99%

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Chronic Lyme Disease: A Review

Marques

2008

Infectious Disease Clinics of North America

173

123

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Section: Chronic Lyme Diseasementioning

confidence: 99%

Section: The Possible Causes Of Post-lyme Disease Symptomsmentioning

confidence: 99%

Section: The Possible Causes Of Post-lyme Disease Symptomsmentioning

confidence: 99%

Section: Studies Of Antibiotic Treatment In Post-lyme Disease Syndromementioning

confidence: 99%

See 2 more Smart Citations

Chronic Lyme Disease: A Review

Marques

2008

Infectious Disease Clinics of North America

173

123

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“…The use of antibiotics in combination with corticosteroids facilitates healing, but corticosteroidsdo not have noticeable effect on motor deficit. In randomized clinical trials no differences were observed among Penicillin G administered in high doses, Ceftriaxone, Cefotaxime and Doxycycline [44].…”

Section: Treatment Of Lyme Neuroborreliosismentioning

confidence: 92%

Diagnosis and Treatment Algorythm in Lyme Neuroborreliosis

Ţilea

Bălaşa

Fodor

et al. 2016

Acta Medica Marisiensis

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Lyme neuroborreliosis is an infection of the nervous system caused by spirochetes of the Borrelia burgdorferi sensulato group. Neurological clinical manifestations usually present a steady evolution and are different in patients from Europe compared to those from America, possibly due to vector agents and different bacterial species. Various diagnostic markers were studied in consideration of a clear or possible diagnosis of the disease, because evolution and complications depend on early diagnosis and initiation of therapy. The isolation of the bacterium is difficult, microscopic examination and the bacterial dezoxiribonucleic acid amplification shows low sensitivity. However, the diagnosis of Lyme neuroborreliosis is mainly based on serological methods that have a satisfactory sensitivity and specificity. A correct diagnosis can be performed by strictly respecting clinical guidelines and protocols and carefully interpreting the serological tests. The presence of anti-borrelia burgdorferi antibodies in the cerebrospinal fluid with evidence of intrathecal antibody production is the gold standard diagnosis of Lyme neuroborreliosis. Early administration of antibiotic treatment (third generation cephalosporins, cyclins, aminopenicillins) can produce the remission of neurological symptoms, the eradication of spirochetes in acute phase of the disease, thus avoiding the development of the chronic disease. Introduction Lyme neuroborreliosis (LNB) is a clinical manifestation of Lyme borreliosis (LB), which affects the central nervous system (CNS) and peripheral nervous system (PNS) caused by spirochetes of the genus Borrelia burgdorferi (Bb) sensulato complex and spread by the bite of ticks of the genus Ixodes. Nerve structures are affected by spirochetes both in acute and late phase of the disease. A distinction between early (acute) and late (chronic) phase of LNB can be made. The acute phase occurs in less than 6 months after contacting an infected arthropod and chronic LNB sets in more than 6 months or even years later after the initial infection [1,2].The clinical manifestations of LNB are various and different in patients from Europe compared to those from America, probably due to different vector agents and bacterial species of the two continents. According to Steere the frequency of neurological manifestations in case of LB is about 15-25% [3].

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