Therapy of Lyme disease Summary

Once Lyme disease has been diagnosed, treatment with antibiotics is necessary. Drug therapy is usually effective in this disease. Problems arise from the necessary, individually very different dosage and the duration of therapy, which makes it necessary to take the respective antibiotic over a period of two to four weeks.

Lyme disease is treated differently depending on the stage of the disease, this is called “stage-appropriate” treatment. A Lyme disease can manifest itself at different localisations of the organism, so that a Lyme disease therapy can be an interdisciplinary task involving doctors from different disciplines. In general, the disease can be divided into three stages according to the symptoms, which are also taken into account in Lyme disease therapy An antibiotic therapy at an early stage is decisive for the further course of the disease, as a longer infestation of the pathogen makes a complete elimination of the pathogen from the organism more difficult.

The failure of an antibiotic therapy in the early stage is only about 10% and increases to about 50% in the late stage, which again shows the importance of an early start of therapy. In the early stage of Lyme disease the antibiotics doxycycline and amoxiciline are mostly used, but they are only two examples of a multitude of preparations which can be used to achieve an optimal therapy for the patient. For example, reasons for excluding certain active substances, such as the presence of renal insufficiency or the age of the patient, to name but two. In the later stage of Lyme disease, ceftriaxone, a cephalosporin antibiotic, is usually prescribed.

Therapy Lyme disease stage 1

In stage I, which is characterized by the characteristic round reddish skin rash, the so-called erythema migrans around the tick’s bite, an antibiotic Lyme disease treatment is carried out for two weeks: It is relevant that Doxycycline is not administered to children under the age of 8 years due to its storage in bones and teeth, because otherwise it can lead to a disturbance of bone growth, underdevelopment of the enamel and yellowing of the teeth. For these reasons, amoxicillin is used in children under the age of 8. In case of non-response to the antibiotic Lyme disease treatment carried out, the antibiotic should be replaced by another one. – Doxycycline (a tetracycline)or

Amoxicillin (an aminopenicillin)

Therapy stage 2 and 3

In more advanced stages, such as stage II and stage III, the antibiotics ceftriaxone and cefotaxim are mainly used. Ceftriaxone and cefotaxim are group 3a cephalosporins and have an extremely broad spectrum of activity. Lyme disease therapy with group 3a cephalosporins must be carried out over a period of three to four weeks.

The administration is intravenous, i.e. the injection takes place directly into a vein. Currently, in stage II and III, other antibiotics are used in addition to the above mentioned group 3a cephalosporins. Other antibiotics can be an alternative in Lyme disease therapy, as it is discussed that group 3a cephalosporins are not sufficiently effective against Borrelia bacteria which are present in the cells and also promote the formation of cystic Borrelia bacteria which are difficult to combat with medication. If the disease flares up again after antibiotic treatment for Lyme disease, it is treated again with another cycle of antibiotics if necessary.