Azithromycin compared with amoxicillin in the treatment of erythema migrans: a double-blind, randomized, controlled trial

Article Abstract:

Treatment with amoxicillin appears to give better results than treatment with azithromycin in patients with symptoms of Lyme disease. Researchers randomly assigned 217 adult patients displaying the typical Lyme disease rash to oral treatment with one of two antibiotics: amoxicillin or azithromycin. Twenty days later, 88% of patients receiving amoxicillin had experienced complete resolution of the rash and relief of 75% or more of accompanying symptoms versus 76% of patients taking azithromycin. All patients taking amoxicillin improved whereas three patients taking azithromycin either did not respond or got worse. Four percent of the amoxicillin group experienced a relapse within 180 days versus 16% of the azithromycin group. Twenty-four percent of the amoxicillin group reported side-effects versus 35% of the azithromycin group. Diarrhea was more common in the azithromycin group. Skin rash led six patients taking amoxicillin to stop therapy.

Azithromycin, Amoxicillin

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Comparison of Culture-Confirmed Erythema Migrans Caused by Borrelia burgdorferi sensu stricto in New York State and by Borrelia afzelii in Slovenia

Article Abstract:

People with Lyme disease may have different symptoms depending on which species of Borrelia they are infected with. Borrelia burgdorferi is the bacterium usually associated with Lyme disease in the US, but in Europe, other species may cause the disease. Researchers compared symptoms in 119 U.S. patients with Borrelia burgdorferi infection and 85 Slovenian patients with Borrelia afzelii infection. The erythema migrans rash lasted longer in the Slovenian patients but the Americans were more likely to have systemic symptoms, abnormal findings on physical examination, and antibodies against the bacterium.

International aspects

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Ceftriaxone compared with doxycycline for the treatment of acute disseminated Lyme disease

Article Abstract:

Ceftriaxone appears to be just as effective in treating Lyme disease as doxycycline. A total of 140 patients with Lyme disease were randomly assigned to take oral doxycycline for 21 days or to receive intravenous or intramuscular ceftriaxone for 14 days. Cure rates were similar in both groups although 57% of the patients receiving ceftriaxone experienced side effects compared to 43% of those taking doxycycline. Patients receiving ceftriaxone were also more likely to have residual symptoms following the treatment.

Doxycycline, Ceftriaxone

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