The Dept. of Health of NJ has published a very useful monograph for physicians to help them understand the complexities of diagnosing LD and utilizing and interpreting the currently available serologic tests. These antibiotics include doxycycline and amoxicillin. Intravenous antibiotics, such as ceftriaxone, should only be used in cases of objective neurologic abnormalities, certain cardiac manifestations, and occasionally in patients with arthritis unresponsive to oral treatment. Other newer antibiotics, such as the macrolides, Zithromax and Biaxin, may be useful. Unfortunately, since the organism cannot be cultured and in vitro sensitivity tests run, good clinical studies to determine the best antibiotic regimens have not been done.
Most data tends to be anecdotal and very difficult to interpret.
Even more difficult to diagnose and treat are the small percentage of patients with LD who develop either the clinical syndrome fibromyalgia or chronic fatigue syndrome. These illnesses do not seem to respond to antibiotic therapy. However, it is important to understand that some patients carrying this diagnosis do not actually have lyme infection. Your physician may want to get a second opinion from an expert in Lyme Disease. Insecticides containing DEET may be useful, but they should be carefully applied as serious side effects may occur if applied in excess to the skin.