Treatment failure in erythema migrans–a review.

 Infection. 1996 Jan-Feb;24,1:73-5. Treatment failure in erythema migrans--a review. Weber
K. Dermatologische Privatpraxis, München, Germany.
Patients with erythema migrans can fail to respond to antibiotic therapy. Persistent or
recurrent erythema migrans, major sequelae such as meningitis and arthritis, survival of Borrelia
burgdorferi and significant and persistent increase of antibody titres against B. burgdorferi
after antibiotic therapy are strong indications of a treatment failure. Most, if not all, antibiotics
used so far have been associated with a treatment failure in patients with erythema migrans.
Roxithromycin and erythromycin are definitely or probab ly ineffective. However, doxycycline,
amoxicillin, cefuroxime, ceftriaxone, azithromycin and high-dose penicillin V perform
comparably well

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