BACKGROUND: @entity7646 antibiotics are highly active in vitro against @entity2069 , but have limited efficacy in the treatment of @entity1 with @entity3001 . As macrolides are less active at a low pH, their poor clinical activity might be due to localization of @entity12732 to an acidic endosome, and their activity improved by alkalinization of that compartment with @entity6383 . MATERIAL/METHODS: 235 @entity1 with a multi-symptom complex typical of chronic @entity3001 , @entity4512 , and @entity149 and with serologic reactivity against @entity2069 were treated with a @entity7646 antibiotic (eg @entity4581 ) and @entity6383 . RESULTS: Eighty % of @entity1 had self-reported improvement of 50% or more at the end of 3 months. After 2 months of treatment, 20% of @entity1 felt markedly improved (75-100% of normal); after 3 months of treatment, 45% were markedly improved. Improvement frequently did not begin until after several weeks of therapy. There were no differences among the three @entity7646 antibiotics used. @entity1 who had been on @entity6383 or @entity7646 antibiotic alone had experienced little or no improvement. Compared to @entity1 ill for less than 3 years, the onset of improvement was slower, and the failure rate higher in @entity1 who were ill for longer time periods. CONCLUSIONS: These results support the hypothesis that the Lyme @entity12732 reside in an acidic endosome and that the use of a lysosomotropic agent augments the clinical activity of @entity7646 antibiotics in the treatment of @entity1 with @entity102 . In contrast, the efficacy of @entity803 in such @entity1 is not affected by @entity6383 .

XXXX therapy of @entity102 .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity4512 :: ('MESH:D059352', 'Disease') :: ['ie fatigue, musculoskeletal pain'] @entity3001 :: ('MESH:D008193', 'Disease') :: ['Lyme Disease', 'Lyme disease'] @entity7646 :: ('CHEBI:25106', 'Chemical') :: ['macrolide', 'Macrolide'] @entity4581 :: ('MESH:D017291', 'Chemical') :: ['clarithromycin'] @entity2069 :: ('139', 'Species') :: ['B.burgdorferi'] @entity149 :: ('MESH:D002493', 'Disease') :: ['neurocognitive dysfunction'] @entity12732 :: ('MESH:D001899', 'Disease') :: ['borrelia'] @entity6383 :: ('MESH:D006886', 'Chemical') :: ['hydroxychloroquine'] @entity102 :: ('MESH:D002908', 'Disease') :: ['chronic Lyme Disease'] @entity803 :: ('MESH:D013752', 'Chemical') :: ['tetracycline']
@entity7646 :: (CHEBI:25106,Chemical) :: ['Macrolide']
