[Antibiotherapy for early localized Lyme disease].

Abstract

OBJECTIVE:

The aim of this article is to provide clinicians with guidelines for the antibiotherapy of early-localized Lyme disease. The outcome measures are the clearance of erythema migrans and associated symptoms of early localized Lyme disease and the prevention rate of late complications, with a low risk of adverse effects. Design. The reviewed studies were selected by Medline with the keywords: "erythema migrans, treatment". Sixteen studies comparing treatment or duration of treatment were analyzed.

RESULTS:

Amoxicillin, doxycycline, and cefuroxim axetil are equally efficacious for early-localized Lyme disease. Azithromycin is an alternative. Most patients respond completely and less than 10% fail to respond. All antibiotics are associated with a low frequency of adverse effects, with the exception of Jarisch Herxheimer reaction which occurs in about 15% of the patients.

CONCLUSIONS:

We recommend treating adults with amoxicillin (50 mg/kg/day in 3 intakes) or doxycycline (100 mg bid) for 14 days (erythema migrans) to 21 days (early localized Lyme disease with associated symptoms). For children, we recommend amoxicillin (50 mg/kg/day in 3 intakes) or doxycycline (4 mg/kg/day in 2 intakes, maximum 100 mg/dose) above 8 years of age. Cefuroxim axetil (500 mg twice daily for adults or 30 mg/kg/day in 2 intakes, maximum 500 mg/dose, for children), and azithromycin (500 mg/day for adults and 20 mg/kg/day for children for 7-10 days) are second line treatment.

• Authors: G Monsel, A Canestri, E Caumes
• Journal: Medecine et maladies infectieuses (Med Mal Infect) 2007 Jul-Aug Vol. 37 Issue 7-8 Pg. 463-72 ISSN: 0399-077X [Print] France
• Vernacular Title: Antibiothérapie de la phase primaire de la borréliose de Lyme.
• PMID: 17412541 (Publication Type: English Abstract, Journal Article, Review)

Chemical References

• Anti-Bacterial Agents

Topics

• Anti-Bacterial Agents (classification, standards, therapeutic use)
• Female
• Humans
• Lyme Disease (classification, drug therapy, physiopathology)
• Microbial Sensitivity Tests
• Practice Guidelines as Topic
• Pregnancy
• Pregnancy Complications, Infectious (drug therapy)