What Did This Study Do
This network meta-analysis included 19 randomised controlled trials involving 2,532 people with erythema migrans due to Lyme disease. No trials were based in the UK most were from the United States or Europe.
Each trial compared two or three antibiotics. Doxycycline was the most frequently used antibiotic. A number of doses and treatment durations were represented. For example, treatment length for doxycycline ranged from 10 to 21 days. For the main analyses, doxycycline was used as the reference treatment.
Both direct and indirect data were extracted from the studies. This approach is helpful when there is a shortage of head to head research, but this, and the overall low quality of included studies means that results need to be treated with some caution.
What Is The Natural History Of Lyme Arthritis
Lyme arthritis is a pain in the butt. However, unlike other types of autoimmune arthritides, it can resolve on its own. Back in the 1980s researchers followed 55 patients who did not receive antibiotics for erythema migrans. They followed these people on average for 6 years.
- 20% had no problems later on.
- 18% had brief episodes of joint and muscle pain, but no swelling, that lasted up to 6 years.
- 51% had intermittent flare-ups of joint swelling primarily involving large joints. Recurrences decreased by 10% to 20% every year.
- 11% developed persistent joint pain and swelling, like you would see in rheumatoid arthritis or psoriatic arthritis.
Its important to note, that these people did NOT receive any antibiotics. Essentially, this is what tends to happen if you do not treat Lyme disease.
What Are The Signs And Symptoms Of Lyme Arthritis
As we previously discussed, Lyme arthritis typically happens 6 months after the first infection but can occur in as little as 4 days and up to 2 years after infection. Although people may experience joint pain, general soreness, and fatigue after Lyme disease even after treatment, Lyme arthritis is actually very different. Lyme arthritis presents like autoimmune joint pain: swelling, redness, warmth, prolonged morning stiffness.
Lyme arthritis typically involves less than 5 joints and they typically are large joints such as the knee. Small joints, like those found in the hands, are hardly ever affected. Sometimes people experience bursitis and tendinitis, and can even have a ruptured Bakers cyst.
The swelling in the knee is usually quite dramatic, but despite the swelling, people usually have less pain than expected. For example, people with a septic knee also typically have a dramatically swollen knee. These people cannot walk, touch, or breathe on the affected knee. People with Lyme arthritis also have a dramatically swollen knee. It also hurts, but they can walk with a limp.
Lyme arthritis is a late manifestation of Lyme disease. By the time it happens, people usually are NOT experiencing constitutional symptoms like fevers, drenching night sweats, or unintentional weight loss.
Don’t Miss: What Happens When You Get Lyme Disease
A Reasonable Approach To Post
If you are being treated for PTLD, there is no magic bullet to treat this problem, but here are some important steps to consider:
- Choose a doctor you trust and who can work closely with you.
- If your doctor agrees to start antibiotics for several months, make sure you talk about the risks and cost, as this can be dangerous and expensive.
- Make sure not to rely solely on antibiotics. The evidence for a benefit from antibiotics is weak, and we rely mostly on physicians clinical experience and interest in the disease to design a personalized therapeutic plan. For some, a more holistic approach may be the way to go.
- If you try supplements, ask about their source and purity, as they are not FDA-regulated.
- Consider looking for services in medical school hospitals or clinics where they may have programs with ongoing research on how to diagnose and treat Lyme.
How Long Does Lyme Disease Last
Lyme disease symptoms can begin anywhere from three to 30 days after transmission of the infection from a tick. If treated early on with antibiotics, most people feel better within a few weeks, says Dr. Zemel.
According to the CDC, its not uncommon for people to experience lingering symptoms like fatigue and joint or muscle pain for a few weeks or months after treatment. Additional antibiotics wont help these symptoms, however, and most people improve on their own over time.
In a small percentage of cases, people continue to experience symptoms for more than six months after their recommended course of antibiotics is completed. This is sometimes referred to as chronic Lyme diseasebut that name is misleading, says Dr. Kuritzkes, because there is no evidence that the bacteria that causes Lyme disease is still present in the body. Instead, the CDC refers to this condition as post-treatment Lyme disease syndrome .
As with many other kinds of infectious diseases, some people are left with some debilitating symptoms that dont go away, says Dr. Kuritzkes. I like to compare it to polio: Some people who had polio are left paralyzed, but that doesnt mean they have chronic polio they have permanent damage from the infection, even after its gone away.
Its possible that Lyme infection leads to some damage that we dont fully understand yet, Dr. Kuritzkes adds. But we do know that long-term or repeated courses of antibiotics have no benefit in these cases.
Don’t Miss: Lyme Disease And Nervous System
Iv Antibiotic Regimen: Cephalosporin Plus Azole Plus Liposomal Cinnamon Clove And Oregano
- ceftriaxone 2 gm IV 2 times a day for 4 days on and 3 days off
- tinidazole 500 mg taken orally 1 pill 2-3 times a day for 4 days on and 3 days off in 7-day cycles
- liposomal cinnamon, clove, and oregano capsules 1 pill 2 times a day
- Various antibiotics can be used as IV. I use this one most commonly because it is the easiest to administer and one of the lowest cost IV regimens. The ceftriaxone is given in a syringe and injected over 10 minutes. This is also a pulse dose regimen . Ceftriaxone could be given daily instead as 2 gm IV 1 time a day.
- I have found various pulse dose regimens of tinidazole to work. These include 2 weeks on and 2 weeks off or in the regimen seen here.
Treatment For Chronic Lyme Disease
Sometimes, people go through treatment for Lyme disease but their symptoms donât go away. If this lasts over 6 months, itâs known as chronic Lyme disease or âpost-treatment Lyme disease syndromeâ .
Doctors still arenât sure why some people get PTLDS. Some believe that getting Lyme disease may cause damage to your tissues or immune system. Others believe itâs because the bacteria that causes Lyme hasnât completely gone away.
There is little evidence that taking more antibiotics at this stage will help. They may actually be harmful. Instead, your doctor will focus on treating the symptoms youâre still having. This will be different for everyone. Some people could benefit from a medicine that relieves fatigue, while others may need a drug that can help with headaches or very sensitive skin.
More research is needed to figure out how best to treat PTLDS. Itâs something that can be frustrating. Just remember: Many people who have this condition do start feeling like their old selves after a few months.
Read Also: What Happens When You Have Lyme Disease
Stage : Early Localized Lyme Disease
Stage 1 or early localized Lyme disease occurs 128 days following a tick bite.
Some people with stage one Lyme disease do not experience any symptoms. If symptoms do occur, they may include the following:
- a skin rash that may or may not resemble a bulls-eye
- flu-like illness, including chills and a fever
- swollen lymph nodes
New Antibiotic A Possible Alternative To Treat Lyme Disease
Posted: 20 October 2021 | Anna Begley |
The antimicrobial hygromycin A was shown to clear Lyme disease in mice, representing a promising therapeutic against the disease.
Researchers at the Northeastern University in Boston and the University of Oklahoma, both US, have identified an antibiotic that may not only work to cure Lyme disease but may also help eradicate its occurrence from the environment.
NEWS: Novel living medicine could treat antibiotic-resistant infections READ HERE
Lyme disease affects an estimated 300,000 people in the US alone. Although early antibiotic treatment is effective for most patients, some 10 to 20 percent of patients continue to suffer from symptoms that may include fatigue, muscle pain and cognitive impairment for over six months after therapy. The significance of this debilitating disease has been recently brought into focus by a set of very similar symptoms in patients with long COVID.
Furthermore, the antibiotics currently used to treat Lyme disease are broad-spectrum with significant effects on the human gut microbiome and the potential for increasing resistance in non-target bacteria. The team therefore sought to identify a compound acting with a narrower spectrum of activity against B. burgdorferi, the bacteria that causes Lyme disease.
This selective antibiotic holds the promise of providing a better therapeutic for treating Lyme disease and eradicating it in the environment
Also Check: Lyme Literate Doctors In Nh
Do Rheumatologists Treat Lyme Disease
Rheumatologiststreating diseasesLyme diseasediseasetreatLyme disease
. Also to know is, what antibiotics are used to treat Lyme disease?
Treatment. People treated with appropriate antibiotics in the early stages of Lyme disease usually recover rapidly and completely. Antibiotics commonly used for oral treatment include doxycycline, amoxicillin, or cefuroxime axetil.
Similarly, what type of arthritis is caused by Lyme disease? Lyme arthritis can be defined as a painful, swollen joint, that causes a stiffness similar to osteoarthritis, and occurs most commonly in the late stages of Lyme disease, usually several months after the onset of the disease.
Secondly, who is the best doctor for Lyme disease?
Healthcare providers who treat Lyme disease include:
- Primary Care Doctors. Your primary care doctor is the place to start.
- Rheumatologists. Rheumatologists specialize in the health needs of people with rheumatic problems.
- Infectious Disease Specialists.
Can azithromycin be used to treat Lyme disease?
Ceftriaxone: Since ceftriaxone is a parenteral medication that may be given IV in the setting of Lyme disease, injection-site pain and tenderness may occur. Rash and diarrhea may also occur. Macrolides : Nausea, vomiting, diarrhea, and rash may occur.
Macrolide Plus Azole Plus Liposomal Essential Oils
- clarithromycin 500 mg 1 pill 2 times a day
- tinidazole 500 mg 1 pill 2 or 3 times a day.
- liposomal cinnamon, clove & oregano oil 1 capsule 2 times a day
- Tinidazole treats cysts and can remove biofilms that block the immune system and antibiotics.
- Liposomal cinnamon, clove & oregano oil can treat persister and growing forms of Lyme. Of the various herbal options to treat persiters – this is my go to persister herbal anti-microbial based on benefits I see in my practice.
You May Like: Medicine For Dogs With Lyme Disease
Treatment For Other Forms Of Lyme Disease
People with other forms of disseminated Lyme disease may require longer courses of antibiotics or intravenous treatment with antibiotics such as ceftriaxone. For more information about treating other forms of Lyme disease, see:
The National Institutes of Health has funded several studies on the treatment of Lyme disease that show most people recover within a few weeks of completing a course of oral antibiotics when treated soon after symptom onset. In a small percentage of cases, symptoms such as fatigue and myalgia can last for more than 6 months. This condition is known as post-treatment Lyme disease syndrome , although it is also sometimes called chronic Lyme disease. For details on research into chronic Lyme disease and long-term treatment trials sponsored by NIH, visit the visit the National Institutes of Health Lyme Disease web siteexternal icon.
Stage : Early Disseminated Lyme Disease
If stage 1 Lyme disease remains undiagnosed and untreated, it can progress to stage 2, or early disseminated, Lyme disease. This stage occurs 312 weeks after the initial tick bite.
The term disseminated indicates that the bacteria have spread throughout the body. At this stage, the infection may affect the following tissues:
- the skin
- nervous system
A person who has progressed to stage 2 Lyme disease may develop new symptoms alongside those from stage 1. These new symptoms may include:
- new rashes across the body
- conjunctivitis or vision problems
- poor memory and concentration
What To Expect At Home
Home care for dogs with Lyme disease is relatively straightforward. Doxycycline is usually given by mouth twice daily for at least 30 days. Improvement in the dogs symptoms should be noted within 24-48 hours. If the dogs condition fails to improve in 72 hours or worsens at any time, call your veterinarian.
Macrolide Plus Grapefruit Seed Extract Plus Cryptolepis
- clarithromycin 500 mg 1 pill 2 times a day
- grapefruit seed extract 250 mg 1 pill 2 times a day.
- cryptolepis 5 ml 3 times a day
- Grapefruit seed extract is better tolerated than both tinidazole and metronidazole and supports killing of Lyme cysts.
- Cryptolepis can treat persister and growing Lyme. If a person also has Babesia, cryptolepis can treat this too.
Don’t Miss: How To Get Diagnosed With Lyme Disease
How Is Lyme Disease Diagnosed And Treated
Lyme disease is usually diagnosed when a person develops a bull’s-eye rash, flu-like symptoms , or both. These symptoms usually start a few days or weeks after the person is bitten by an infected tick.
A two-step blood test can verify the presence of Lyme disease antibodies, although it does take a few weeks for those antibodies to develop. And despite what some physicians and advocacy groups claim, a blood test is the only way Lyme disease can be confirmed, Larry Zemel, MD, head of rheumatology at Connecticut Childrens Medical Center, tells Health. Some doctors say they can diagnose Lyme even when patients test negative repeatedly, but that has not been borne out by any scientific study, he says.
When people are diagnosed with Lyme disease in its early stages, a 10- to 20-day course of oral antibioticsusually with a drug called doxycyclinewill clear the infection and help them feel better fairly quickly. This cures the vast majority of people, and they have a 100% recovery with no lasting effects, says Dr. Zemel.
If Lyme disease isnt diagnosed right away, it can cause more serious symptoms like arthritis and memory problems. These people may need a full month of oral antibiotics, says Dr. Zemel. About 20% of these patients will need IV antibiotics , and they may also need other medications to treat symptoms like pain and muscle stiffness.
What Does Current Guidance Say On This Issue
NICE guidance on Lyme disease states that those without focal symptoms should receive 100mg oral doxycycline twice a day or 200mg once per day for 21 days. The first alternative to this is oral amoxicillin, 1g three times per day for 21 days and the second alternative is oral azithromycin, 500mg daily for 17 days.
You May Like: How To Heal From Lyme Disease
Why This Is Important
The use and duration of antibiotics for chronic Lyme disease treatment is controversial because there is no biomarker that can determine whether the Lyme bacteria has been eradicated in CLD patients. Patients are often told that either chronic Lyme disease does not exist or that it is incurable. If this were true, we would not expect more well and substantially improved patients to be taking antibiotics. Instead, we might have expected the percentage of people using antibiotics to be roughly the same among the patient subgroups.
Tetracycline Plus Macrolide Plus Grapefruit Seed Extract Plus Japanese Knotweed
- doxycycline 100 mg 2 pills 2 times a day
- clarithromycin 500 mg 1 pill 2 times a day
- grapefruit seed extract 250 mg 1 pill 2 times a day.
- Japanese knotweed½ tsp 3 times a day
- Tetracyclines and macrolides both block protein production by binding to the protein production apparatus in germs called ribosomes. But they each bind to a different part of the ribosome improving the blockade of protein production.
- Japanese knotweed is added here to treat persister Lyme. It also may treat growing Lyme and can lower inflammation cytokines.
Read Also: What To Expect With Lyme Disease
Possible Alternative Treatment For Lyme Disease
- University of Oklahoma
- Researchers have described a new antibiotic that appears to have the potential to cure Lyme disease.
As if COVID and RSV weren’t bad enough, incidents of Lyme disease — a potentially serious disease caused by the bacteria Borrelia burgdorferi and transmitted following a bite of an infected deer tick — also are on the rise in the United States.
Lyme disease affects an estimated 300,000 people in the United States alone. Humans and animals can be infected with B. burgdorferi following the bite of an infected deer tick, also known as the black-legged tick. About 80% of those who contract the disease will develop a bulls-eye rash around or near the site of the bite anywhere from three to 30 days following the bite.
Although early antibiotic treatment is effective for most patients, some 10-20% of patients continue to suffer from symptoms that may include fatigue, muscle pain and cognitive impairment for over six months after therapy. The significance of this debilitating disease has been recently brought into focus by a set of very similar symptoms in patients with “Long COVID.”
The antibiotics currently used to treat Lyme disease are broad-spectrum with significant effects on the human gut microbiome and the potential for increasing resistance in non-target bacteria, Zgurskaya explained, adding that the team sought to identify a compound acting with a narrower spectrum of activity against B. burgdorferi.