The best antibiotics to treat Borrelia miyamotoi?

Borrelia miyamotoi may be a disease you have never heard of. But the threat of this tick-borne illness is very real. First described in Japan in 1995, this emerging infectious disease is transmitted by the same blacklegged tick which carries the Lyme disease pathogen. In “Antimicrobial susceptibility of Borrelia miyamotoi,” researchers examine the effectiveness of several antibiotic regimes in the treatment of HTBRF.

 

In the United States, as many as 15.4% of the blacklegged ticks were found to be infected with B. miyamotoi, compared with up to 4% in Europe and Japan, according to Koetsveld from the Center for Experimental and Molecular Medicine, Academic Medical Center, Amsterdam, the Netherlands. [1]

Meanwhile, “Seroprevalence studies in New England suggest that B. miyamotoi infection may be as common as anaplasmosis and babesiosis,” write the authors of one study. The researchers randomly tested 250 individuals living in Manitoba, Canada and found that 10% were seropositive for B. miyamotoi. [2]

Although B. miyamotoi is characterized by relapsing fever, a case series published in the Annals of Internal Medicine reports that only 2 out of 50 patients infected with B. miyamotoi actually exhibited a relapsing fever. [3]

“Recurrent fever episodes have only been observed in 10% [of the cases] and spirochetemia is calculated to be low in patients infected with B. miyamotoi,” Koetsveld explains in Antimicrobial Agents Chemotherapy. [1]

Fever episodes last for three days and are accompanied by flu-like symptoms such as headache, chills, abdominal discomfort, arthralgia and myalgia.

So, how do we treat this difficult to diagnose condition?

Until now, there have been no treatment guidelines for B. miyamotoi and regimes have been empirically based on the treatment for Lyme disease. “The antimicrobial susceptibility of B. miyamotoi has not yet been elucidated, due to difficulties with cultivation of B. miyamotoi spirochetes in vitro,” according to Koetsveld.

What is the best way to treat Borrelia miyamotoi? Click To Tweet

“In this study we describe, to our knowledge for the first time, in vitro susceptibility of B. miyamotoi to the most commonly used antibiotics” in the treatment of B. miyamotoi and Lyme borreliosis.

The study authors demonstrated that B. miyamotoi is susceptible to doxycycline, azithromycin, and ceftriaxone but resistant to amoxicillin in vitro. The next step would be to show whether these drugs work in patients.

Note: This article was originally published July 19, 2017. It has been updated with new content. 

References:
  1. Koetsveld J, Draga ROP, Wagemakers A, et al. In vitro susceptibility of the relapsing fever spirochete Borrelia miyamotoi to antimicrobial agents. Antimicrob Agents Chemother. 2017.
  2.  Kadkhoda K, Dumouchel C, Brancato J, Gretchen A, Krause PJ. Human seroprevalence of Borrelia miyamotoi in Manitoba, Canada, in 2011-2014: a cross-sectional study. CMAJ Open. 2017;5(3):E690-E693.
  3. Molloy PJ, Telford Iii SR, Chowdri HR, Lepore TJ, Gugliotta JL, Weeks KE, Hewins ME, Goethert HK, Berardi VP: Borrelia miyamotoi Disease in the Northeastern United States: A Case Series. Ann Intern Med 2015.
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Nancy
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Nancy

My son has Down syndrome 28 years old. Imugen labs results b miyamotoi IGM negative. B miyamotoi IGG positive. igenex testing shows lyme western blot **41. And borreliosis 41 intermediate. He is on amoxicillian 875 2x day. Was on augmentin then doxcy. He goes off within 1 week foot blows up hot red. Been going on few years

Debra
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Debra

Tiffany…I posted my story on 2-18-2019…I feel like im fighting a loosing battle..I rarely have a good day…I stopped going to doctors when acquiring a staph infection after under going a simple endoscopy procedure…I have become intolerant of alot of foods since this all took place.have constant headaches…The nauseasness make it hard for me to eat..So weight gain is almost impossible..I could go on and on..But if you read my prior post that will explain most..You stated that you feel like your finslly starting to get your life back…What have you done? Antibiotics have destroyed my stomach..Any input would be… Read more »

Tiffany
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Tiffany

Was bit by something/contracted what looked like poison ivy in May 2017 which erupted up my left arm via an itchy but bubbly patch, & eventually full body mini rashes. By October I was tired, had a cough, constant post nasal drip, had left ear fullness, pulsatlle tinnitus in my left ear as well. By the end of October, I ended up in the ER when I felt like I was drunk driving home, yet had nothing to drink. My ceiling fan was oscillating when it was actually not even turned on! I was nauseous, heart palpation, dizzy, ear fullness… Read more »

Valerie
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Valerie

Tiffany, I live in Boston and I’m 42. I’ve had a terrible time here at the “big” hospitals with getting proper diagnoses. They all sent me away saying my Lyme tests were negative last year. A blood testing lab in Germany, Armin Labs, finally gave me accurate blood tests with all of my tick-borne infections recently. I have Borrelia Myamotoi and Burgdorferi, Babesia Microti, Bartonella Henslae, and several other co-infections. Did any of those meds you were taking actually cure/ eradicate the Myamotoi?? I’m completely overwhelmed and feel like I want to die. Which pill form are you taking??

Nancy
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Nancy

Has anyone who has posted here tried minocycline. I have found it will diminish the arthritic and neurological disorders of these nasty TBD’s. I am speaking from my own experience and from observing my dog who has RMSF. We also consumed honeycomb which eliminated most of the pain(better than Alleve).

Walter Taylor
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Walter Taylor

Former Land Surveyor’s Health Deterioration & Being Marginalized Due to Lyme in California Igenex Laboratory near San Jose, CA developed a new immunoblot test in late 2018 for “TBRF”, which is tick-borne relapsing fever. TBRF is a medically recognized chronic category of Borrelli species variants and according to the California Department of Public Health is endemic to California. In 2008, the National Institutes of Health published a clinical symptoms & treatment guidelines on the diagnosis of Tick-Borne Relapsing Fever.  https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=18755384. I have all the symptoms of TBRF: including CNS involvement with cranial nerve palsies-relapsing/remitting episodes of diplopia, exophoria & iradocyclides.… Read more »

Lyme Disease
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I was bitten by a couple of ticks in Europe. Fever, spotted rash, acne like eruptions on my back, headache, paranoia, light-sound sensitivity and relapsing fevers and swollen lymph nodes. I didn’t leave my bed for three months. Prior I worked 70 hours a week, lifted weights daily and was fit and healthy. I didn’t test positive for rickettsia which they suspected due to spotted rash, they found Bartonella through antibody test (due to lymphadenopathy it was tested). Lyme disease was negative. However I developed Bell’s Palsy and delayed reflexes which is not a typical neurological sign that Bartonella causes.… Read more »

Jamie Leigh
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Jamie Leigh

I was diagnosed with Borrelia miyamotoi and a M. pneumoniae co-infection via urinalysis (DNA Connexions) in October 2018. This was after five months of episodes that presented like a heart attack: heart racing/palpitations, left arm/neck/jaw numbness, chest and back pain, dizziness, nausea. I was in the ER six times and hospitalized twice. I went to three cardiologists, had countless tests and monitoring performed. One diagnosed “Inappropriate Sinus Tachycardia,” but another (more reputable) cardiologist disagreed, and felt that, despite episodes of heart rate up to 154 bpm, I was not in danger. This cardiologist suggested a neurological abnormality of some sort;… Read more »

Debra
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Debra

I was sick with what I thought was the flu in February of 2018. I generally don’t get the flu or the flu vaccine. I thought it was a little strange I was actually laid up in bed for almost 6 weeks with typical flu symptoms. I hadn’t had the flu since I was about 21 years old I am now 58. I didn’t feel well after the 6 weeks. And continued not feeling well. And my husband kept telling me to go to the doctor. I don’t go to the doctor very often because I have been misdiagnosed over… Read more »

Maria
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Maria

I too was diagnosed in 2015. I’m pretty much in a wheelchair.

Pat
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Pat

I was diagnosed with it as well…positive pcr and antibody…been sick for 5 years.

Cindy
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Cindy

I have Borrelia miyamotoi. It almost killed me! I still suffer terribly with this tick born illness. My blood was sent to a lad in Massachusetts. A standard blood test didn’t pick this disease up. I went to a specialist in NYC. He sent my blood to three different lads. The only lab that picked this up was the Massachusetts lab. Borrelia miyamotoi Has taken 16 months of my life. It’s a very serious!

Jen
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Jen

I was just diagnosed with miyamotoi. How are you doing now, Cindy?

Amy
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Amy

What Dr did u see? I think my daughter has lymes

katherine c girouard
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katherine c girouard

Could you please let me know what lab was used in Mass for your blood test? Thanks kat