Comparison of a Two- or Three-Week Regimen and a Review of Treatment of Erythema Migrans with Phenoxymethylpenicillin

Abstract

Background: A longer duration treatment is preferred in erythema migrans (EM) to prevent late complaints. Objectives: To determine whether 20 (20d-pt) or 14 days (14d-pt) of phenoxymethylpenicillin (PenV) have similar efficacy in treating EM and preventing further sequelae. Patients and Methods: In a prospective double-centre study, 102 patients with EM were treated with PenV 1.5 million IU thrice daily for either 20 or 14 days and followed up for 12 months. Results: The primary cure rate after treatment with PenV was 91.5% (79.6–97.6) for 20d-pt vs. 91.7% (77.5–98.2) for 14d-pt; p > 0.99). In 7 patients (4/20d-pt and 3/14d-pt), persistent or newly arising symptoms required retreatment. After 1 year, all patients were cured. The immune response showed no statistical difference between the treatment groups in the follow-up period. Conclusion: A 2-week treatment regimen of PenV seems to be as effective as a 3-week course with no statistical differences for clinical and serological findings after treatment.

Course of Antibody Response in Lyme Borreliosis Patients before and after Therapy

“…These patients received antibiotic treatment with phenoxymethylpenicillin 1500 000 IE threetimes a day, 26 patients for 14 days and 35 patients for 20 days. No statistical difference in the clinical outcome of the differently treated groups was observed during the 12-month observation period as described in a previous study [2].…”

Immunoblot Analysis of the Seroreactivity to Recombinant <i>Borrelia burgdorferi </i>sensu lato Antigens, Including VlsE, in the Long-Term Course of Treated Patients with Erythema Migrans

“…In untreated cases, spirochetal dissemination may lead to other organ manifestations, including neurological, musculoskeletal or cardiac disorders [2]. Adequate antibiotic treatment usually resolves EM as well as extracutaneous symptoms within days to weeks, although (intermittent) complaints may sometimes clear slowly [2, 3]. Subsequent objective neurological, cardiac or joint manifestations of LB develop in a minority of patients [2, 4].…”

<i>Borrelia burgdorferi</i>-Associated Primary Cutaneous Marginal-Zone B-Cell Lymphoma: A Case Report

“…The spirochete Borrelia burgdorferi has been identified as the aetiological agent of Lyme disease and of several skin manifestations of that, including erythema chronicum migrans, lymphocytoma cutis and acrodermatitis chronica atrophicans [1,2,3,4,5]. An association between B. burgdorferi with primary cutaneous B-cell lymphoma (PCBCL) has long been suspected but just recently, thanks to a polymerase chain reaction (PCR) technique, it had been possible to demonstrate B. burgdorferi- specific DNA in skin lesions of patients with different primary cutaneous B-cell lymphoma subtypes [6,7,8,9,10].…”