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Lyme Disease Treatment

Nearly all Lyme disease patients can be effectively treated with an appropriate course of antibiotic therapy. In general, the sooner such therapy is begun following infection, the quicker and more complete the recovery.

Antibiotics, such as doxycycline, cefuroxime axetil, or amoxicillin taken orally for a few weeks, can speed the healing of the erythema migrans rash and usually prevent subsequent symptoms such as arthritis or neurological problems. Doxycycline will also effectively treat most other tick-borne diseases.

Patients younger than 9 years or pregnant or lactating women with Lyme disease are treated with amoxicillin, cefuroxime axetil, or penicillin because doxycycline can stain the permanent teeth developing in young children or unborn babies. Patients allergic to penicillin are given erythromycin.

Lyme disease patients with neurological symptoms are usually treated with the antibiotic ceftriaxone given intravenously once a day for a month or less. Most patients experience full recovery.

Lyme arthritis may be treated with oral antibiotics. Patients with severe arthritis may be treated with ceftriaxone or penicillin given intravenously. To ease these patients' discomfort and further their healing, the physician might also give anti-inflammatory drugs, draw fluid from affected joints, or surgically remove the inflamed lining of the joints.

Lyme arthritis resolves in most patients within a few weeks or months following antibiotic therapy, although it can take years to disappear completely in some people. Some Lyme disease patients who are untreated for several years may be cured of their arthritis with the proper antibiotic regimen. If the disease has persisted long enough, however, it may irreversibly damage the structure of the joints.

Physicians prefer to treat Lyme disease patients experiencing heart symptoms with antibiotics such as ceftriaxone or penicillin given intravenously for about 2 weeks. If these symptoms persist or are severe enough, patients may also be treated with corticosteroids or given a temporary internal cardiac pacemaker. People with Lyme disease rarely experience long-term heart damage.

Following treatment for Lyme disease, some people still have muscle achiness, neurologic symptoms such as problems with memory and concentration, and persistent fatigue. NIH-sponsored researchers are conducting studies to determine the cause of these symptoms and how to best treat them.

Researchers are also currently conducting studies to assess the optimal duration of antibiotic therapy for the various manifestations of Lyme disease. Investigators are also testing newly developed antibiotics for their effectiveness in countering the Lyme disease bacterium.

Unfortunately, a bout with Lyme disease is no guarantee that the illness will be prevented in the future. The disease can strike more than once in the same individual if he or she is reinfected with the Lyme disease bacterium.

References and Sources: Medline, Pubmed, National Institutes of Health

last update: December 2008


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