Azithromycin versus doxycycline for treatment of erythema migrans: clinical and microbiological findings.

Infection. 1993 Mar-Apr;21,2:83-8. Azithromycin versus doxycycline for treatment of erythema migrans: clinical and microbiological findings. Strle F, Preac-Mursic V, Cimperman J, Ruzic E, Maraspin V, Jereb M.

Department of Infectious Diseases, University Medical Center, Ljubljana, Slovenia.

The effectiveness of azithromycin and doxycycline in the treatment of erythema migrans was compared in a prospective randomized trial. One hundred seven adult patients with typical erythema migrans, examined in the Lyme Borreliosis Outpatients’ Clinic, University Department of Infectious Diseases in Ljubljana, were included in the study. Fifty-five patients received azithromycin, 500 mg twice daily for the first day, followed by 500 mg once daily for four days, and 52 patients received doxycycline, 100 mg twice daily for 14 days. The mean duration of skin lesions after the beginning of treatment was 7.5 +/- 5.9 days, median value 5, range 2-28 days, in the azithromycin group and 11.4 +/- 7.8 days, median value 9, range 2 days–8 weeks, in the doxycycline group, p < kappa =” 0.54″> or = 1 month, only 7, 37 percent, had positive tests, P < n =” 43,” n =” 38;” p =” 0.03;” p =” 0.03;” p =” 0.04,” p =” 0.04.” p =” 0.02,” p =” 0.01,” n =” 6],” n =” 4],” n =” 3].” p =” 0.03,” p =” .002,” p =” .03,” p =” .04,” p =” .02,” p =” .004,” p =” .04,” p =” .01,” n =” 10,” p =” .06.” n=”97,” n=”86,” n=”15,” p =” 0.001.”> 4 mg/L. Comparison of MBC values after 3 and 6 weeks’ incubation revealed comparable results for azithromycin and ceftriaxone while for amoxicillin, cefuroxime and doxycycline, some differences were found. In one of the patients from whom there were borrelia isolated before and after treatment with cefuroxime axetil, both isolates were resistant to cefuroxime. In the other two patients, the paired isolates were susceptible to the antibiotic used for therapy.





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