Could Longer-Term Antibiotic Treatment Benefit Lyme Disease Patients?

Patients with persistent Lyme disease symptoms do not benefit from longer-term antibiotic treatment, according to new research.

Treatment options for persistent Lyme disease symptoms have long been debated. Therefore, researchers wanted to investigate the benefits of longer-term treatments versus shorter-term treatments in patients with persistent Lyme disease symptoms.
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To conduct their study, researchers randomly selected 281 patients in Europe with persistent Lyme disease symptoms—including musculoskeletal pain, arthritis, and arthralgia—to receive oral doxycycline, clarithromycin plus hydroxychloroquine, or placebo for 12 weeks.

Before starting oral treatment, all patients received open-label intravenous ceftriaxone for 2 weeks.

In addition, researchers used the physical-component summary score of the RAND-36 Health Status Inventory to assess patients’ quality of life after receiving the intravenous treatment, after completing the oral treatment, and after final follow-up.

At the 14-week follow-up, researchers found that the quality of life scores did not differ much among the groups: The doxycycline group had a mean score of 35.0, the clarithromycin-hydroxychloroquine group had 35.6, and the placebo group had 34.8.

Quality of life scores did not change significantly between the groups at different intervals. However, scores did increase significantly from baseline to final follow-up in all groups.

“In patients with persistent symptoms attributed to Lyme disease, longer-term antibiotic treatment did not have additional beneficial effects on health-related quality of life beyond those with shorter-term treatment,” researchers concluded.

—Amanda Balbi

Reference:
Berende A, ter Hofstede HJM, Vos FJ, et al. Randomized trial of longer-term therapy for symptoms attributed to Lyme disease. N Engl J Med. 2016; 374:1209-1220.