Longer-Term Antibiotics Won't Ease This
Dutch trial is latest to show no benefit from extended treatment, but finding unlikely to end the controversy
By Steven Reinberg
WEDNESDAY, March 30, 2016 (HealthDay News) -- People with persistent symptoms associated with Lyme disease are unlikely to find relief from longer-term antibiotic therapy, according to a new Dutch study.
Although antibiotics are the correct therapy to treat Lyme disease when it is diagnosed early, longer-term use appears ineffective against the symptoms linked to the tick-borne illness and may carry the risk of side effects, the researchers said.
"Most patients with Lyme disease are cured after initial antibiotic therapy. But, up to 20 percent of patients report persistent symptoms, such as muscular or joint pain, fatigue or concentration problems, despite initial antibiotic therapy," said study senior researcher Dr. Bart-Jan Kullberg. He is a professor of infectious diseases at Radboud University Medical Center in Nijmegen, the Netherlands.
Treating these patients with longer courses of antibiotics has been controversial, Kullberg said. "Previous clinical trials have not shown that prolonged antibiotic treatment has beneficial effects in patients with persistent symptoms attributed to Lyme disease. Nonetheless, the debate about this issue has continued," he said.
The major conclusion from this new study is that three months of antibiotic therapy does not provide additional benefits to patients reporting persistent symptoms of pain, fatigue or mental confusion, he said.
"These patients need customized care, not just a prescription for antibiotics," Kullberg said.
The study findings were published March 31 in the New England Journal of Medicine.
The debate over what's often called chronic Lyme disease dates back almost as far as the discovery of the illness 40 years ago. Many sufferers insist that chronic Lyme is a very real disease. But many medical experts say the symptoms could be those of an undiagnosed illness in patients.
The new study included 280 patients in Europe who suffered from symptoms such as muscle and joint pain, fatigue and concentration problems, and were previously diagnosed with Lyme disease.
During the first two weeks of the trial, all the patients were given the antibiotic ceftriaxone (Rocephin). Then they were randomly divided into three groups. The first group was given the antibiotic doxycycline (Doryx) for 12 weeks; the second group was given a combination of the antibiotics clarithromycin (Biaxin) and hydroxychloroquine (Plaquenil); and the third group was given a placebo.