Effects of penicillin, ceftriaxone, and doxycycline on morphology of Borrelia burgdorferi.

 Antimicrob Agents Chemother. 1995 May;39,5:1127-33. Effects of penicillin, ceftriaxone,
and doxycycline on morphology of Borrelia burgdorferi. Kersten A, Poitschek C, Rauch S,
Aberer E.
Department of Dermatology, University of Vienna, Austria.
Antibiotic therapy with penicillin, doxycycline, and ceftriaxone has proven to be effective for the
treatment of Lyme borreliosis. In some patients, however, it was noticed that borreliae can
survive in the tissues in spite of seemingly adequate therapy. For a better understanding of this
phenomenon, we investigated the different modes of degeneration of Borrelia burgdorferi
suspensions during a 96-h exposure to various antibiotics. By dark-field microscopy and
ultrastructural investigations, increasing blebbing and the gradual formation of granular and
cystic structures could be followed during the exposure time. Although antibiotic concentrations
at the MIC at which 90% of organisms are inhibited after 72 h were 80% or even greater, motile
organisms were still present after incubation with penicillin and doxycycline but not after
incubation with ceftriaxone. By transmission electron microscopy, intact spirochetal parts,
mostly situated in cysts, were seen up to 96 h after exposure with all three antibiotics tested.
According to experiences from studies with other spirochetes it is suggested that encysted
borreliae, granules, and the remaining blebs might be responsible for the ongoing antigenic
stimulus leading to complaints of chronic Lyme borreliosis




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