TREATMENT

Antimicrobial agents are the principle method of treatment of Lyme disease infection. The antibiotic used depends on the stage of the disease, symptoms, and the patients allergies to medication. The length of the course of antibiotics depends on the stage of the disease and severity of symptoms.

Early Lyme disease is typically treated with a 14-21 day course of oral antibiotics. Doxycycline, clarithromycin, or amoxicillan are most commonly used. The failure rate for these interventions at this stage is less than 5%. [16]

Pharmacological therapy for early disseminated Lyme disease is more aggressive. The same agents as for treatment of early Lyme disease are used, though they are intravenously and for a longer course (up to 28 days). Penicillin G may also be used in treatment of carditis leading to AV conduction abnormalities and in encephalitis. [17]

Anti-inflammatory agents are often used to treat arthritis secondary to Lyme infection. Other agents, such as antidepressants, may be prescribed for palliation of some of the chronic psychological symptoms of Lyme disease, such as depression, mood changes, and anxiety.

PROGNOSIS

Proper treatment of Lyme disease with antimicrobial agents yields a fairly good prognosis, especially in children. Lyme disease, even untreated, is almost never fatal. Cranial nerve palsies and carditis usually resolve quickly even without treatment. Arthritis and neurological symptoms does not generally resolve as swiftly, especially in adults, but are generally much improved with treatment. Some psychological symptoms, especially memory deficits, decreased concentration, and fatigue may not resolve for months or years following infection. [18]