TY - JOUR
T1 - Treatment of Lyme disease
AU - Steere, Allen C.
AU - Green, Jerry
AU - Hutchinson, Gordon J.
AU - Rahn, Daniel W.
AU - Pachner, Andrew R.
AU - Schoen, Robert T.
AU - Sigal, Leonard H.
AU - Taylor, Elise
AU - Malawista, Stephen E.
N1 - Funding Information:
During 1980 and 1981, we randomly assigned 108 adult patients to treatment with either phenoxymethyl penicillin, erythromycin, or tetracycline therapy, in each in- 1 Grant Support in part by V .S. Public Health Service grants AM-20358, AM-07107, and RR 00125, and the Arthritis Foundation and its Connecticut Chapter .
PY - 1987
Y1 - 1987
N2 - We compared phenoxymethyl penicillin, erythromycin, and tetracycline, in each instance 250 mg four times a day for 10 days, for the treatment of early Lyme disease (stage 1). None of 39 patients given tetracycline developed major late complications compared with 3 of 40 penicillin-treated patients and 4 of 29 given erythromycin (p = 0.07). However, with all three antibiotic agents, nearly half of patients had minor late symptoms. For neurologic abnormalities (stage 2), 12 patients were treated with high-dose intraveous penicillin, 20 million U a day for 10 days. Pain usually subsided during therapy, but a mean of 7 to 8 weeks was required for complete recovery of motor deficits. For the treatment of established arthritis (stage 3), 20 patients were assigned treatment with intramuscular benzathine penicillin (7.2 million U) and 20 patients received saline. Seven of the 20 penicillin-treated patients (35%) were apparently cured, but all 20 patients given placebo continued to have attacks of arthritis (P < 0.02). Of 20 arthritis patients treated with intravenous penicillin G, 20 million U a day for 10 days, 11 (55%) were apparentely cured. Thus, all 3 stages of Lyme disease can be treated with antibiotic therapy, but some patients with late disease may not respond.
AB - We compared phenoxymethyl penicillin, erythromycin, and tetracycline, in each instance 250 mg four times a day for 10 days, for the treatment of early Lyme disease (stage 1). None of 39 patients given tetracycline developed major late complications compared with 3 of 40 penicillin-treated patients and 4 of 29 given erythromycin (p = 0.07). However, with all three antibiotic agents, nearly half of patients had minor late symptoms. For neurologic abnormalities (stage 2), 12 patients were treated with high-dose intraveous penicillin, 20 million U a day for 10 days. Pain usually subsided during therapy, but a mean of 7 to 8 weeks was required for complete recovery of motor deficits. For the treatment of established arthritis (stage 3), 20 patients were assigned treatment with intramuscular benzathine penicillin (7.2 million U) and 20 patients received saline. Seven of the 20 penicillin-treated patients (35%) were apparently cured, but all 20 patients given placebo continued to have attacks of arthritis (P < 0.02). Of 20 arthritis patients treated with intravenous penicillin G, 20 million U a day for 10 days, 11 (55%) were apparentely cured. Thus, all 3 stages of Lyme disease can be treated with antibiotic therapy, but some patients with late disease may not respond.
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U2 - 10.1016/S0176-6724(87)80092-5
DO - 10.1016/S0176-6724(87)80092-5
M3 - Article
C2 - 3109144
AN - SCOPUS:0023139427
SN - 0176-6724
VL - 263
SP - 352
EP - 356
JO - Zentralblatt fur Bakteriologie Mikrobiologie und Hygiene - Abt. 1 Orig. A
JF - Zentralblatt fur Bakteriologie Mikrobiologie und Hygiene - Abt. 1 Orig. A
IS - 3
ER -