Duration of Antibiotic Therapy for Lyme Disease
Authors: Allen C. Steere
Journal: Annals of Internal Medicine (2003)

Editorials6 May 2003Duration of Antibiotic Therapy for Lyme DiseaseAllen C. Steere, MDAllen C. Steere, MDFrom Massachusetts General Hospital; Boston, MA 02114.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-138-9-200305060-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Erythema migrans, an expanding annular skin lesion, was described in Europe in the early 20th century (1). In the 1950s, before the cause of the illness was known, European physicians noted that erythema migrans could be treated successfully with penicillin (2). After the description of Lyme arthritis in the United States in 1976, it became apparent that erythema migrans was the initial manifestation of a complex, multisystem illness. It was then shown that oral penicillin G given for 10 days shortened the duration of erythema migrans and often prevented or attenuated subsequent arthritis (3).In 1980 and 1981, 108 patients ...References1. Afzelius A. Erythema chronicum migrans. Acta Derm Venereol (Stockh). 1921;2:120-5. Google Scholar2. Hollstrm E. Successful treatment of erythema migrans Afzelius. Acta Derm Venereol (Stockh). 1951;31:235-43. MedlineGoogle Scholar3. Steere AC, Malawista SE, Newman JH, Spieler PN, Bartenhagen NH. Antibiotic therapy in Lyme disease. Ann Intern Med. 1980;93:1-8. [PMID: 6967272] LinkGoogle Scholar4. Steere AC, Hutchinson GJ, Rahn DW, Sigal LH, Craft JE, DeSanna ET, et al. . Treatment of the early manifestations of Lyme disease. Ann Intern Med. 1983;99:22-6. [PMID: 6407378] LinkGoogle Scholar5. Dattwyler RJ, Volkman DJ, Conaty SM, Platkin SP, Luft BJ. Amoxycillin plus probenecid versus doxycycline for treatment of erythema migrans borreliosis. Lancet. 1990;336:1404-6. [PMID: 1978873] CrossrefMedlineGoogle Scholar6. Massarotti EM, Luger SW, Rahn DW, Messner RP, Wong JB, Johnson RC, et al. . Treatment of early Lyme disease. Am J Med. 1992;92:396-403. [PMID: 1313637] CrossrefMedlineGoogle Scholar7. Nadelman RB, Luger SW, Frank E, Wisniewski M, Collins JJ, Wormser GP. Comparison of cefuroxime axetil and doxycycline in the treatment of early Lyme disease. Ann Intern Med. 1992;117:273-80. [PMID: 1637021] LinkGoogle Scholar8. Dattwyler RJ, Luft BJ, Kunkel MJ, Finkel MF, Wormser GP, Rush TJ, et al. . Ceftriaxone compared with doxycycline for the treatment of acute disseminated Lyme disease. N Engl J Med. 1997;337:289-94. [PMID: 9233865] CrossrefMedlineGoogle Scholar9. Luft BJ, Dattwyler RJ, Johnson RC, Luger SW, Bosler EM, Rahn DW, et al. . Azithromycin compared with amoxicillin in the treatment of erythema migrans. A double-blind, randomized, controlled trial. Ann Intern Med. 1996;124:785-91. [PMID: 8610947] LinkGoogle Scholar10. 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Science. 1998;281:703-6. [PMID: 9685265] CrossrefMedlineGoogle Scholar15. Donta ST. Tetracycline therapy for chronic Lyme disease. Clin Infect Dis. 1997;25 Suppl 1 S52-6. [PMID: 9233665] CrossrefMedlineGoogle Scholar16. Klempner MS, Hu LT, Evans J, Schmid CH, Johnson GM, Trevino RP, et al. . Two controlled trials of antibiotic treatment in patients with persistent symptoms and a history of Lyme disease. N Engl J Med. 2001;345:85-92. [PMID: 11450676] CrossrefMedlineGoogle Scholar17. Wormser GP, Nadelman RB, Dattwyler RJ, Dennis DT, Shapiro ED, Steere AC, et al. . Practice guidelines for the treatment of Lyme disease. The Infectious Diseases Society of America. Clin Infect Dis. 2000;31 Suppl 1 1-14. [PMID: 10982743] CrossrefMedlineGoogle Scholar18. Steere AC. Lyme disease. N Engl J Med. 2001;345:115-25. [PMID: 11450660] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Massachusetts General Hospital; Boston, MA 02114.Disclosures: None disclosed.Corresponding Author: Allen C. Steere, MD, Massachusetts General Hospital, 149 13th Street, Room 8301, Charlestown, MA 02129. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoDuration of Antibiotic Therapy for Early Lyme Disease Gary P. Wormser , Roshan Ramanathan , John Nowakowski , Donna McKenna , Diane Holmgren , Paul Visintainer , Rhea Dornbush , Brij Singh , and Robert B. Nadelman Duration of Antibiotic Therapy for Lyme Disease Raphael B. Stricker and Edward L. McNeil Duration of Antibiotic Therapy for Lyme Disease Allen C. Steere Metrics Cited ByLate Manifestations of Lyme BorreliosisLyme BorreliosisLyme diseaseBorréliose de LymeBorreliosis de LymeDiagnosis, treatment, and prognosis of erythema migrans and Lyme arthritisThe Clinical Assessment, Treatment, and Prevention of Lyme Disease, Human Granulocytic Anaplasmosis, and Babesiosis: Clinical Practice Guidelines by the Infectious Diseases Society of AmericaACVIM Small Animal Consensus Statement on Lyme Disease in Dogs: Diagnosis, Treatment, and PreventionLa maladie de Lyme du point de vue de l'ophtalmologueDuration of Antibiotic Therapy for Lyme DiseaseRaphael B. Stricker, MD and Edward L. McNeil, MD 6 May 2003Volume 138, Issue 9Page: 761-762KeywordsAntibioticsDoxycyclineErythemaErythromycinFatigueInfectious diseasesLyme diseaseMeningitisPenicillinTetracyclines ePublished: 6 May 2003 Issue Published: 6 May 2003 CopyrightCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...