MedPage Today reported, March 30, on the effects of long-term antibiotic treatment for patients reporting persistent Lyme disease. A randomized study of 280 people undertaken in the Netherlands found no clinical improvement in patients treated with a variety of antibiotic protocols. This echos other studies on the topic.
Persistent Lyme disease or chronic Lyme disease is called Post-treatment Lyme Disease Syndrome (PTLDS) by the Centers for Disease Control and Prevention. It consists of a wide variety of symptoms experienced by some patients who believe or have been told that they contracted Lyme disease. No specific treatment has been found though some physicians prescribe long-term treatment with antibiotics.
Testing for Lyme disease is a challenge. The CDC recommends that testing be performed only in patients having symptoms and who have been potentially exposed to bites from the black-legged tick, the disease vector. Many patients diagnosed with chronic Lyme disease do not test positive for the bacterium Borrelia burgdorferi which causes the illness.
The title of the study is Randomized Trial of Longer-Term Therapy for Symptoms Attributed to Lyme Disease and it was put online by the New England Journal of Medicine on March 31. A majority of the patients reported at least one adverse side effect, attributed to antibiotic treatment. An accompanying editorial in the Journal has this to say:
Patients with subjective, vexing symptoms attributed to Lyme disease should not anticipate that even longer courses of antibiotics will produce relief
The CDC notes that some patients with PTLDS have had success with treatments designed for patients with fibromyalgia or chronic fatigue syndrome. The Centers also note that similar symptoms “are known to occur following other infections, including Campylobacter (Guillain-Barre syndrome), Chlamydia (Reiter’s syndrome), and Strep throat (rheumatic heart disease).” They encourage patients to work with their physician to treat their symptoms and to become knowledgeable about their condition.