Journal article
Antibiotic treatment duration and long-term outcomes of patients with early lyme disease from a lyme disease-hyperendemic area
Clinical infectious diseases, Vol.50(4), pp.512-520
02/15/2010
DOI: 10.1086/649920
PMID: 20070237
Abstract
The length of antibiotic therapy and long-term outcomes in patients with early Lyme disease are incompletely described. We report the long-term clinical outcomes of patients with early localized and early disseminated Lyme disease based on the duration of antibiotic therapy prescribed.
A retrospective cohort study and follow-up survey of patients diagnosed as having early localized and early disseminated Lyme disease from 1 January 2000 through 31 December 2004 was conducted in a Lyme disease-hyperendemic area.
Six hundred seven patients met the study inclusion criteria. Most patients (93%) were treated with doxycycline for treatment durations of 10 days, 11-15 days, or 16 days in 17%, 33%, and 47% of doxycycline-treated patients, respectively. Treatment failure criteria, defined before performing the study, were met in only 6 patients (1%). Although these 6 patients met a priori treatment failure criteria, 4 of these patients' clinical details suggested reinfection, 1 was treated with an inappropriate antibiotic, and 1 developed facial palsy early in therapy. Reinfection developed in 4% of patients. The 2-year treatment failure-free survival rates of patients treated with antibiotics for 10 days, 11-15 days, or 16 days were 99.0%, 98.9%, and 99.2%, respectively. Patients treated with antibiotics for 16 days had lower 36-item Short-Form Health Survey social functioning scores on the follow-up survey. No other differences were found in follow-up clinical status or 36-item Short-Form Health Survey scores by duration of antibiotic treatment.
Patients treated for 10 days with antibiotic therapy for early Lyme disease have long-term outcomes similar to those of patients treated with longer courses. Treatment failure after appropriately targeted short-course therapy, if it occurs, is exceedingly rare.
Details
- Title: Subtitle
- Antibiotic treatment duration and long-term outcomes of patients with early lyme disease from a lyme disease-hyperendemic area
- Creators
- Todd J Kowalski - Section of Infectious Disease and Departments of Medical Education, Gundersen Lutheran Medical Foundation, La Crosse, WI 54601. USA. TJKowals@gundluth.orgSujatha TataWendy BerthMichelle A MathiasonWilliam A Agger
- Resource Type
- Journal article
- Publication Details
- Clinical infectious diseases, Vol.50(4), pp.512-520
- DOI
- 10.1086/649920
- PMID
- 20070237
- ISSN
- 1058-4838
- eISSN
- 1537-6591
- Language
- English
- Date published
- 02/15/2010
- Academic Unit
- General Internal Medicine; Internal Medicine
- Record Identifier
- 9984094210602771
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