title: Cases of Lyme borreliosis resistant to conventional treatment: improved symptoms with cephalosporin plus specific beta-lactamase inhibition.
abstract: We present four cases of verified late Lyme borreliosis with persistent symptoms and positive serology despite repeated courses of high-dose intravenous penicillin G and/or cephalosporins (including cefoperazone). The patients were now treated with cefoperazone 2 g plus sulbactam 1 g bid iv for 14 days. At the end of treatment, patients were symptom free and have remained so for the following 12 months. By then, IgG against Borrelia burgdorferi had decreased. It is concluded that the addition of beta-lactamase inhibitors to intravenous treatment could be beneficial in Lyme disease refractory to conventional treatment.
authors.affiliation: Department of Medicine, University of Graz, Austria.
authors.forename: R
authors.initials: R
authors.lastname: Gasser
authors.forename: E
authors.initials: E
authors.lastname: Reisinger
authors.forename: B
authors.initials: B
authors.lastname: Eber
authors.forename: R
authors.initials: R
authors.lastname: Pokan
authors.forename: G
authors.initials: G
authors.lastname: Seinost
authors.forename: J
authors.initials: J
authors.lastname: Berglöff
authors.forename: R
authors.initials: R
authors.lastname: Horwarth
authors.forename: B
authors.initials: B
authors.lastname: Sedaj
authors.forename: W
authors.initials: W
authors.lastname: Klein
mesh_terms: D002438:Cefoperazone / Q000008:administration & dosage / Q000627:therapeutic use*; D002511:Cephalosporins / Q000008:administration & dosage / Q000627:therapeutic use*; D004352:Drug Resistance, Microbial; D004359:Drug Therapy, Combination / Q000008:administration & dosage / Q000627:therapeutic use*; D004791:Enzyme Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008193:Lyme Disease / Q000188:drug therapy* / Q000382:microbiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D013407:Sulbactam / Q000008:administration & dosage / Q000627:therapeutic use*; D065093:beta-Lactamase Inhibitors
chemical_list: D002511:Cephalosporins; D004791:Enzyme Inhibitors; D065093:beta-Lactamase Inhibitors; D002438:Cefoperazone; D013407:Sulbactam