Are antibiotics used to treat Lyme disease effective?
As the number of individuals contracting Lyme disease grows, along with an ever increasing number of patients suffering from chronic symptoms, the question often arises as to whether antibiotics used to treat Lyme disease are actually effective?
An article entitled “Antibiotic treatment in patients that present with solely non-specific symptoms and positive serology at a Lyme centre,” published in the European Journal of Internal Medicine, ¹ describes a study which addresses the question: Are short-term antibiotics used to treat Lyme disease effective in patients whose symptoms are subjective?
The study examined 97 patients who presented with non-specific symptoms and had no previous treatment for Lyme disease but were positive by immunoglobulin G (IgG) serology tests.
“Non-specific” symptoms included:
- Fatigue (includes lethargy and loss of energy)
- Sleep disturbances
- Inﬂammatory symptoms (includes fever, temperature rise, sore throat, and night sweats)
- Cognitive disorder
- Sensory disorder
- Digestive disorder
- Shortness of breath/palpitations
- Mood disorder
Researchers looked at whether these patients would benefit from antibiotics used to treat Lyme disease and whether certain patient characteristics contributed to treatment success.
They found that nearly 50% of patients “had a clear or intermediate effect from antibiotic treatment.”
Most of the 97 patients were adults. Over 70% were men. And, the non-specific symptoms had been present for an average of 2 years.
Doxycycline was one of the antibiotics used to treat Lyme disease. The remaining patients received amoxicillin. A 4-week course was prescribed to most of the patients. Interestingly, patients with inflammatory symptoms benefited the most from doxycycline.Does a short course of antibiotics help Lyme disease patients who have non-specific symptoms, like fatigue, mood disturbances and sleep disturbances? Click To Tweet
Furthermore, “patients with symptoms suggestive for inflammatory disease and patients with the IgG immunoblot antigen p58 benefited significantly more often from antibiotic treatment compared to patients without these characteristics,” the authors point out.
Of the 97 patients who improved with antibiotics, 15.5% had a clear eﬀect from antibiotic treatment, while 26.8% had an intermediate eﬀect and 50.5% experienced no effect.
“This study shows that antibiotics possibly have an effect on non-specific symptoms in previously untreated patients with positive Borrelia serology,” the authors conclude.
“However, these beneficial effects were intermediate in a considerable amount of patients.”
The authors suggest, an RCT [randomized clinical trial] “is needed to validate our ﬁndings, relevant for clinicians in Lyme centres.”
They also point out that an improvement of symptoms may have been the result of eradicating another pathogen and not Borrelia burgdorferi, the causative agent of Lyme disease.
“Symptoms suggestive for inflammatory disease were associated with treatment effect. This could indicate an effect of antibiotic treatment on pathogens related to diseases other than LB [Lyme borreliosis].”
Studies dispute antibiotic benefits
Meanwhile, findings from the Klempner clinical trial, sponsored by the National Institutes of Health (NIH), suggest that antibiotics used to treat Lyme disease would not be beneficial to patients with non-specific symptoms.²
However, that trial enrolled patients who had been ill an average of 4.7 years and who had already failed an average of 2 treatments.
Another trial, also sponsored by the NIH, found that antibiotics would be helpful but only for Lyme disease patients suffering from fatigue and not for other non-specific symptoms.³
The study featured in the European Journal of Internal Medicine has several limitations. Treatment effectiveness may have been due to a pathogen other than Lyme disease. And there was no controlled study population.
That said, the results should encourage additional research on the benefits of antibiotics used to treat Lyme disease patients who suffer from non-specific symptoms.
- Nijman G, van Kooten B, Vermeeren YM, van Hees BC4, Zomer TP. Antibiotic treatment in patients that present with solely non-specific symptoms and positive serology at a Lyme centre. Eur J Intern Med. 2020 Feb 15.
- Klempner MS, Hu LT, Evans J, Schmid CH, Johnson GM, Trevino RP, et al. Two
controlled trials of antibiotic treatment in patients with persistent symptoms and a
history of lyme disease. N Engl J Med 2001;345:85–92. https://doi.org/10.1056/
- Krupp LB, Hyman LG, Grimson R, Coyle PK, Melville P, Ahnn S, et al. Study and
treatment of post lyme disease (STOP-LD): a randomized double masked clinical