Ceftriaxone Compared with Doxycycline for the Treatment of Acute Disseminated Lyme Disease

Abstract

In patients with acute disseminated Lyme disease but without meningitis, oral doxycycline and parenterally administered ceftriaxone were equally effective in preventing the late manifestations of disease.

Chronic Lyme Disease: A Review

“…From 10-20% of such patients have persistent or intermittent subjective symptoms of mild to moderate intensity 12 months after completion of therapy ( Table 4). The most common postLyme disease symptoms are fatigue, arthralgias, myalgias, headache, neck stiffness, paresthesias, sleeplessness, irritability, and difficulty with memory, word finding, and concentration [12,13,[25][26][27][28]. The appearance of post-Lyme disease symptoms seems to correlate with disseminated disease, a greater severity of illness at presentation, and delayed antibiotic therapy [12,[29][30][31][32][33]; but not with the duration of the initial antibiotic therapy [13,23].…”

Persister Development by Borrelia burgdorferi Populations In Vitro

“…Doxycycline acts on the bacterial 30S ribosomal subunit (19), while ceftriaxone can generally be described as having beta-lactam activity (20). Although previous clinical studies showed that doxycycline can be as effective as third-generation cephalosporin antibiotics like ceftriaxone (21,22), recent in vitro work suggests that doxycycline may not be as effective as ceftriaxone against stationaryphase bacteria (23). Importantly, the role of immune responses to infection is integral to the treatment mode for microbiostatic an-tibiotics like doxycycline, such that results from in vitro studies should not be overinterpreted to the in vivo situation.…”

Serological and Clinical one year follow-up of Patients with Erythema migrans treated in a Romanian Infectious Disease Hospital

“…Seropositivity to Borrelia burgdorferi sl, either at presentation or follow-up, was found in independent studies not to be a risk factor for treatment failure. [23,[25][26][27][28][29] Persistence of IgM and IgG antibodies was described even 10-20 years after infection in asymptomatic patients. [30] It might be assumed that sustained positive titers indicate a long-term serologic memory that results from an antigen-independent polyclonal activation and differentiation of memory B cells.…”