Assessment of the efficacy of an
antibiotic drug used in patients with various manifestations of dermatoborreliosis is crucial. Clinical judgement alone (resolution of the present dermatologic lesion, prevention of later major or minor sequelae) is not sufficient in
erythema migrans and
acrodermatitis chronica atrophicans. Thus, laboratory tests are desirable to prove the benefit of an
antimicrobial agent. It was intended to establish a constant parameter--besides the clinical picture--for assessing the efficacy of
antibiotic treatment in patients with dermatoborreliosis in terms of eradication of Borrelia burgdorferi from the site of
infection. Polymerase chain reaction (PCR) was therefore performed from pretreatment biopsy specimens from lesional skin of 36
erythema migrans patients (m:f = 15:21, mean age 49 years) and seven
acrodermatitis chronica atrophicans patients (m:f = 0:7, mean age 59 years), respectively. After
antibiotic therapy with
minocycline (100 mg, orally twice daily, 14 days) for
erythema migrans, and
ceftriaxone (2 g, intravenously once daily, 14 days) for
acrodermatitis chronica atrophicans another punch biopsy was obtained and analysed by PCR. In pretreatment specimens, B. burgdorferi-specific
DNA was amplified by PCR in 23/36
erythema migrans patients (69%), and in 5/7
acrodermatitis chronica atrophicans patients (71%). After
antibiotic therapy, PCR yielded negative results in all of these cases. Clinically, all patients showed complete recovery or at least marked improvement of lesions at this time. PCR appears to be a reliable parameter for the assessment of the efficacy of
antibiotic treatment in dermatoborreliosis.