Treatment of the Early Manifestations of Lyme Disease

Abstract

During 1980 and 1981, antibiotic regimens in 108 adult patients with early Lyme disease were compared. Erythema chronicum migrans and its associated symptoms resolved faster in penicillin- or tetracycline-treated patients than in those given erythromycin (mean duration, 5.4 and 5.7 vs. 9.2 days, F = 3.38, P < 0.05). None of 39 patients given tetracycline developed major late complications (meningoencephalitis, myocarditis or recurrent attacks of arthritis) compared with 3 of 40 penicillin-treated patients and 4 of 29 given erythromycin (.chi.2 with 2 degrees of freedom = 5.33, P = 0.07). In 1982, all 49 adult patients were given tetracycline; again, none of them developed major complications. With all 3 antibiotic agents nearly half of the patients had minor late symptoms such as headache, musculoskeletal pain and lethargy. These complications correlated significantly with the initial severity of illness. For patients with early Lyme disease, tetracycline appears to be the most effective drug, the penicillin and finally erythromycin.