Lyme borreliosis treatment

Abstract

Lyme borreliosis is the most common human tick-borne illness in the Northern Hemisphere. The causative agent is the spirochete Borrelia burgdorferi species complex, and the hard-shell ticks of the genus Ixodes is responsible for pathogen transmission from animals to humans. The incidence of the disease is increasing year by year and although lyme disease is not fatal, it can affect the skin, heart, nervous, and musculoskeletal system with an impairment of quality of life. The appropriate diagnosis of lyme disease should be promptly treated by antibiotics to prevent late stage of the disease. The choice of antibiotics depends on many factors such as the stage of the disease, the drug efficacy, adverse effects, type of delivery, duration of treatment, and cost. Treatment failure occurs as a result of many reasons, re-infection is possible. The recommended treatment schedule in the Czech Republic is presented.

Borrelia burgdorferi sensu lato serology in the Netherlands: guidelines versus daily practice

“…Since many guidelines, i.e. the European ESGBOR, the North-American IDSA and the Dutch CBO are [4,5,8], to a large extent, in accordance with each other on two-tier testing and case definitions, and since the incidence of LB in the Netherlands is similar to other European countries, our results most likely could be extrapolated to other European countries [3,6,7,19].…”

“…These recommendations are in line with other national guidelines, such as the Dutch health organization "Centraal Begeleidings Orgaan" (CBO) guideline from 2013 and other European and international guidelines, including the guideline published in 2006 by the Infectious Disease Society of America (IDSA) [5][6][7][8]. According to these guidelines, the diagnosis of LB is based on the presence of specific symptoms, and-when appropriate (see below)-combined with positive serological and/or other diagnostic tests.…”

Lyme disease/borreliosis as a systemic disease

“…91 Borrelia can be cultured in vitro in Barbour, Stoenner, and Kelly (BSK) medium from skin, blood, CSF, and synovial fluid; however, it takes several weeks to obtain the culture result and therefore culture is not routinely done. 16 Skin biopsies may show positivity with culture or PCR in 50-70% cases. 88…”

Chronic Lyme disease: the controversies and the science

“…This controversy primarily exists in the public dialogue, as the concept of chronic Lyme disease is not widely accepted within the scientific or clinical community. At least 19 independent societies representing the USA and numerous European countries have produced remarkably similar clinical practice guidelines for Lyme disease, discouraging the diagnosis of chronic Lyme disease and recommending against treating patients with prolonged or repeated antibiotic courses [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27]201]. These recommendations are also shared by national public health agencies throughout the Lyme-endemic world.…”