MyLymeData study provides some answers. One of the thorniest issues in Lyme disease has to do with the use of antibiotics. According to the Infectious Diseases Society of America (IDSA) and Centers for Disease Control and Prevention, 2-4 weeks of antibiotic treatment is more than enough to knock out the illness.
It is not uncommon for patients treated for Lyme disease with a recommended 2 to 4 week course of antibiotics to have lingering symptoms of fatigue, pain, or joint and muscle aches at the time they finish treatment. In a small percentage of cases, these symptoms can last for more than 6 months.
As mentioned earlier, the Lyme-disease bacteria can damage nerves. Depending on the amount of damage, it can simply take months for the nerves to heal, even long after the bacteria are gone. The good news is that they eventually do heal. Almost all people with Post-treatment Lyme Disease Syndrome eventually feel better.
Peripheral nerve involvement: When the peripheral nerves are affected, patients can develop radiculoneuropathy which can cause numbness, tingling, “shooting” pain, or weakness in the arms or legs. Central nerve involvement: When the central nervous system is affected, Lyme meningitis can cause fever, headache, sensitivity to light, and stiff neck.
Most people with Lyme disease respond well to antibiotics and fully recover. Varying degrees of permanent nervous system damage may develop in people who do not receive treatment in the early stages of illness and who develop late-stage Lyme disease.
Antibiotics. Antibiotics such as those named above can be used in the treatment of late-stage, chronic, and “disseminated” (CDC) Lyme disease. Some doctors, including Lyme-literate doctors, prescribe longer-term antibiotic programs than the typical 2-4 week regimen.
Early localized Lyme disease — Early localized Lyme disease (the erythema migrans rash, with or without flu-like symptoms) is treated with oral antibiotics, usually doxycycline, amoxicillin, or cefuroxime, taken daily. Doxycycline is given for 10 to 21 days, and amoxicillin and cefuroxime are given for 14 to 21 days.
Previous uncontrolled trials and recent placebo-controlled trials suggest that prolonged antibiotic therapy (duration, <4 weeks) may be beneficial for patients with persistent Lyme disease symptoms. Tickborne coinfections may increase the severity and duration of infection with B. burgdorferi.
Neurologic conditions associated with late Lyme disease are treated with intravenous antibiotics, usually ceftriaxone or cefotaxime, given daily for two to four weeks.
The neurologic abnormalities of stage 3 Lyme disease involve both the central and peripheral nervous systems. Typical presentations include subacute encephalopathy, chronic progressive encephalomyelitis, and late axonal neuropathies, as well as symptoms consistent with fibromyalgia.
The guidelines have consistently recommended a 10-day course of doxycycline for uncomplicated early Lyme disease.
Doxycycline is considered the first-line drug of choice for Lyme disease by most physicians.
In the majority of cases, it is successfully treated with oral antibiotics. In some patients, symptoms, such as fatigue, pain and joint and muscle aches, persist even after treatment, a condition termed “Post Treatment Lyme Disease Syndrome (PTLDS)”.
Lyme disease is caused by infection with the bacterium Borrelia burgdorferi. Although most cases of Lyme disease can be cured with a 2- to 4-week course of oral antibiotics, patients can sometimes have symptoms of pain, fatigue, or difficulty thinking that last for more than 6 months after they finish treatment.
Any antibiotic can cause skin rashes, and if an itchy red rash develops while on antibiotics, a patient should see their physician. Sometimes symptoms worsen for the first few days on an antibiotic. This is called a Herxheimer reaction and occurs when the antibiotics start to kill the bacteria.
“Post-treatment Lyme disease syndrome (PTLDS) is a real disorder that causes severe symptoms in the absence of clinically detectable infection,” says John N.