Tetracycline therapy for chronic Lyme disease.

 Clin Infect Dis. 1997 Jul;25 Suppl 1:S52-6.  Tetracycline therapy for chronic Lyme disease.
Donta ST.
Boston University Medical Center and Boston Veterans Affairs Medical Center, Massachusetts 
02118, USA.
Two hundred seventy-seven patients with chronic Lyme disease were treated with tetracycline 
for 1 to 11 months, mean, 4 months; the outcomes for these patients were generally good. 
Overall, 20% of the patients were cured; 70% of the patients' conditions improved, and treatment 
failed for 10% of the patients. Improvement frequently did not take place for several weeks; after 2 
49months of treatment, 33% of the patients' conditions were significantly improved, degree of 
improvement, 75%-100%, and after 3 months of treatment, 61% of the patients' conditions were 
significantly improved. Treatment outcomes for seronegative patients, 20% of all patients, were 
similar to those for seropositive patients. Western immunoblotting showed reactions to one or 
more Borrelia burgdorferi-specific proteins for 65% of the patients for whom enzyme-linked 
immunosorbent assays were negative. Whereas age, sex, and prior erythema migrans were not 
correlated with better or worse treatment outcomes, a history of longer duration of symptoms 
or antibiotic treatment was associated with longer treatment times to achieve improvement 
and cure. These results support the use of longer courses of treatment in the management of 
patients with chronic Lyme disease. Controlled trials need to be conducted to validate these 
observations




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