Treatment and prevention of Lyme disease, with emphasis on antimicrobial therapy for neuroborreliosis and vaccination.
Antibiotic therapy is recommended for all forms of neuroborreliosis. Although stage 2 neuroborreliosis will usually resolve without any treatment, antibiotic therapy has been associated with faster resolution of symptoms and may prevent additional non-neurologic disease manifestations. Ceftriaxone is the most convenient parenteral agent for stage 2 and 3 neuroborreliosis because of its once-daily dosage. Available data indicate that a 2-4-week treatment course is adequate for most patients. Patients with isolated seventh nerve palsy may be treated with an oral agent (for example, doxycycline). Recombinant outer surface protein A of Borrelia burgdorferi is a highly protective immunogen for prevention of Lyme disease in experimental animals. Humoral immunity is sufficient for protection. A recombinant OspA vaccine has been licensed for prevention of Lyme disease in dogs. Licensure of an OspA vaccine for humans will depend on a critical analysis of the results of recently completed efficacy studies.
Wormser
G P
GP
Division of Infectious Diseases, New York Medical College, Valhalla, USA.
D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001428:Bacterial Vaccines; D015748:Borrelia burgdorferi Group / Q000276:immunology; D004285:Dogs; D006801:Humans; D008193:Lyme Disease / Q000150:complications / Q000517:prevention & control* / Q000628:therapy*; D009422:Nervous System Diseases / Q000188:drug therapy* / Q000209:etiology
D000900:Anti-Bacterial Agents; D001428:Bacterial Vaccines