The Infectious Diseases Society of America or IDSA came out with guidelines on the treatment of the infection.
A multidisciplinary group, which prepared these guidelines, included infectious disease specialists, rheumatologists, neurologists, pediatricians, and entomologists. The guidelines primary apply to the disease strain acquired in the U.S. And do not tackle the diagnostic evaluation of the disease. They recommended oral and parenteral therapies according to a timetable. Doxycycline or amoxicillin, cefotaxime or penicillin would be prescribed. The guidelines warned against the use of first-generation cephalosporins, fluoroquinolones, and benzathene penicillin.
Greater Recovery Among Children
Studies conducted on 177 children treated for Lyme neuroborreliosis in an endemic area in Sweden showed that 117 of them recovered complete in two months.
The children exhibited fatigue, facial nerve palsy, loss of appetite and fever as symptoms. Antibiotics were given to 69% of the children. At 2 months, 117 of them recovered completely. At 6 months, 140 of the remaining also recovered. None reported progressive or recurring symptoms.
The vaccine Lymerix has been proven to be effective in 76% of individuals who received it according to a recommended schedule.
Its side effects were reported to be minimal, consisting of three days of arthralgias and myalgias and sores in 25% of them on the injection site. The American Committee on Immunization Practices of the Centers for Disease Control said that it should be administered in endemic and high-risk areas for ticks. The vaccine would be more cost-effective in those areas.
One study revealed a 1%+ of $53,100 ratio per quality-adjusted life saved with the use of the vaccine.
Another study showed $640. It is approved for adults aged 15 to 70 who should receive boosters yearly or every two years to maintain immunity. Lyme disease can be re-acquired, but an expert suggested that a later-stage will not develop a second new case. When treatment fails, a second course should be applied. The regimen, however, will be useless with late neurologic abnormalities. When the patient's condition stabilizes, oral therapy should complete the course.
Bransfield, Robert C. 2001. Lyme neuroborreliosis and aggression. Action Lyme. 21-23
(April).Available from http://actionlyme.50megs.com/neuroborreliosis%20aggression.htm
-. 2009. Lyme, depression and suicide. Canlyme. 18 (April). Available
-. 2009. The neuro-psychiatric assessment of lyme disease. Mental Health and Illness. Available from http://www.mentalhealthandillness.com/tnaold.html
Boggs, Will. 2008. Most children recover from lyme neuroborreliosis without sequelae.
Pediatric Infectious Diseases Journal. Available from http://www.medscape.com/viewarticle/586114
Cohen, Marcus. 2004. Lyme disease: the ABCs. Townsend Letter for Doctors and Patients. (May). Available from http://findarticles.com/p/article/mi_mOISW/is_250/ai_n6112457/?tag=content;col1
Fallon, Brian et al. 1995. Late-stage neuropsychiatric lyme borreliosis differential diagnosis and treatment. Psychosomatics. 36:295-300. Available from http://www.wadhurst.demon.co.uk/lyme/lyme101.htm
Faul, John L, et al. 1999. Tick-borne pulmonary disease -- update on diagnosis and treatment. Chest. 116 (1): 222-230. Available from http://www.medscape.com/viewarticle/416978
Rupprecht, Tobias A. et al. 2008. The pathogenesis of lyme neuroborreliosis from infection to inflammation. Molecular Medicine. March-April 14 (3-4): 205-212.
Available from http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2148032
Stricker, R. B and Johnson, Lorraine. 2009. Chronic lyme disease and the "axis of evil."
Future Microbiology. 3 (6): 621-624. Available from http://www.medscape.com/viewarticle/586226
Smith, Robert, et al. 2000. Lyme disease surveillance in England and Wales, 1986-98.
Emergency Infectious Diseases. 6 (4). Available from http://www.medscape.com/viewarticle/414744
Shadick, Nancy. 1999. Lyme disease: clinical update. Disclosures. Available from http://www.medscape.com/viewarticle/423777
Weinstein, Robert A. 2000. Treatment of lyme disease. Disclosures. Available from http://www.medscape.com/viewarticles/423777
Marcus Cohen, "Lyme disease: the ABCs ." Townsend Letter for Doctors and Patients (May 2004)
ibid ibid ibid
Robert Smith, "Lyme disease surveillance in England and Wales, 1986-1998." Emergency Infectious Diseases. (2000)
Robert C. Bransfield, "The Neuro-psychiatric Assessment of Lyme disease." Mental Health and Illness (2009)
Brian Fallon et al., "Late-stage neuropsychiatric borreliosis differential diagnosis and treatment." Psychosomatics
Tobias A. Rupprecht et al. "The pathogenesis of Lyne Neuroborreliosis: from Infection to Inflammation." Molecular Medicine. (March-April 2008)
Raphael B. Stricker and Lorraine Johnson, "Chronic Lyme disease and the "axis of evil." Medscape. (March 2008)
Robert C. Bransfield, "Lyme Neuroborreliosis and aggression." Action Lyme. (April 21-23 2001)
Robert C. Bransfield, "Lyme, depression and suicide." Canlyme. (April 18, 2009)
John L. Faul et al., "Tick-borne pulmonary disease -- update on diagnosis and treatment." Chest. (1999)
Robert A. Weinstein, "Treatment of Lyme disease." Disclosures. (2000)
Will Boggs, "Most Children Recover from Lyme Neuroborreliosis without Sequelae." Pediatric Infectious Diseases Journal. (2008)