Successful Parenteral Penicillin Therapy of Established Lyme Arthritis

Allen C. Steere, Jerry Green, Robert T. Schoen, Elise Taylor, Gordon J. Hutchinson, Daniel Wallace Rahn, Stephen E. Malawista

Research output: Contribution to journalArticle

Abstract

In a double-blind placebo-controlled trial carried out from 1980 to 1982, 20 patients with established Lyme arthritis were assigned treatment with 2.4 million U of intramuscular benzathine penicillin weekly for three weeks (total, 7.2 million U) and 20 patients received saline. Seven of the 20 penicillin-treated patients (35 per cent) had complete resolution of arthritis soon after the injections and have remained well during a mean follow-up period of 33 months. In contrast, all 20 patients given placebo continued to have attacks of arthritis (P<0.02). In 1983, of 20 patients treated with intravenous penicillin G, 20 million U a day for 10 days, 11 (55 per cent) had complete resolution of arthritis and have remained well since. As compared with nonresponders, penicillin-responsive patients in both studies were more likely to have previously received antibiotics for erythema chronicum migrans (P<0.02) and less likely to have been given intraarticular corticosteroids during or at the conclusion of parenteral therapy (P<0.1). The Lyme spirochete was not cultured from synovium or joint fluid. We conclude that established Lyme arthritis can often be treated successfully with parenteral penicillin. However, neither of the regimens that we tested is uniformly effective, and further experience will be needed to determine the optimal course of therapy. (N Engl J Med 1985; 312:869–74.).

Original languageEnglish (US)
Pages (from-to)869-874
Number of pages6
JournalNew England Journal of Medicine
Volume312
Issue number14
DOIs
StatePublished - Apr 4 1985
Externally publishedYes

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Lyme Disease
Penicillins
Arthritis
Erythema Chronicum Migrans
Therapeutics
Placebos
Penicillin G Benzathine
Spirochaetales
Penicillin G
Synovial Membrane
Adrenal Cortex Hormones
Joints
Anti-Bacterial Agents
Injections

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Steere, A. C., Green, J., Schoen, R. T., Taylor, E., Hutchinson, G. J., Rahn, D. W., & Malawista, S. E. (1985). Successful Parenteral Penicillin Therapy of Established Lyme Arthritis. New England Journal of Medicine, 312(14), 869-874. https://doi.org/10.1056/NEJM198504043121401

Successful Parenteral Penicillin Therapy of Established Lyme Arthritis. / Steere, Allen C.; Green, Jerry; Schoen, Robert T.; Taylor, Elise; Hutchinson, Gordon J.; Rahn, Daniel Wallace; Malawista, Stephen E.

In: New England Journal of Medicine, Vol. 312, No. 14, 04.04.1985, p. 869-874.

Research output: Contribution to journalArticle

Steere, AC, Green, J, Schoen, RT, Taylor, E, Hutchinson, GJ, Rahn, DW & Malawista, SE 1985, 'Successful Parenteral Penicillin Therapy of Established Lyme Arthritis', New England Journal of Medicine, vol. 312, no. 14, pp. 869-874. https://doi.org/10.1056/NEJM198504043121401
Steere, Allen C. ; Green, Jerry ; Schoen, Robert T. ; Taylor, Elise ; Hutchinson, Gordon J. ; Rahn, Daniel Wallace ; Malawista, Stephen E. / Successful Parenteral Penicillin Therapy of Established Lyme Arthritis. In: New England Journal of Medicine. 1985 ; Vol. 312, No. 14. pp. 869-874.
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