Treatment of Lyme Disease

Introduction to Lyme Disease Treatment

• The Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), and American College of Rheumatology (ACR) strongly recommend against additional antibiotic therapy for patients with persistent or recurring nonspecific symptoms following recommended treatment for Lyme disease 2
• The American College of Rheumatology (ACR) recommends oral antibiotic therapy for 28 days for Lyme arthritis 2
• The American College of Rheumatology (ACR) suggests 14-21 days of total antibiotic therapy for Lyme carditis, with oral options including doxycycline, amoxicillin, cefuroxime axetil, and azithromycin 2

Neurological Manifestations of Lyme Disease

• The American College of Rheumatology (ACR) recommends IV ceftriaxone, cefotaxime, penicillin G, or oral doxycycline for 14-21 days for neurological manifestations of Lyme disease 3

Clinical Considerations for Lyme Disease

• Evidence of persistent infection or treatment failure would include objective signs of disease activity, such as arthritis, meningitis, or neuropathy, not just subjective symptoms 2
• For borrelial lymphocytoma, oral antibiotic therapy for 14 days with doxycycline, amoxicillin, or cefuroxime axetil is recommended, but this does not include antimalarials 4