Comparison of azithromycin and doxycycline in the treatment of erythema migrans.
BACKGROUND
A randomized, multicenter, open clinical trial was undertaken in order to compare the efficacies of azithromycin and doxycycline in the treatment of patients with Lyme disease associated with erythema migrans.


METHODS
A total of 48 patients was treated orally with azithromycin, 500 mg bid on the 1st day, followed by 500 mg once daily for the next 4 days or doxycycline (40 patients) 100 mg bid for 14 days.


RESULTS
Intention-to-treat analysis of clinical efficacy showed no difference between the two treatment regimens. Clinical success was observed in 46 (95.8%) azithromycin- and 33 (82.5%) doxycycline-treated patients, (p = 0.0731). Minor symptoms persisted or appeared in the posttreatment period in two of 47 azithromycin- and three of 35 doxycycline-treated patients (p = 0.646). Major manifestations appeared only in two patients in the doxycycline group (p = 0.179). There was no difference in the tolerability of both drugs.


CONCLUSIONS
Azithromycin (a total dose of 3 g) is equally effective as standard doxycycline treatment for erythema migrans in adult patients.
Barsic
B
B
University Hospital for Infectious Diseases, Zagreb, Croatia. bruno.barsic@fran.bfm.hr
Maretic
T
T
Majerus
L
L
Strugar
J
J
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017963:Azithromycin / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D017523:Croatia; D004318:Doxycycline / Q000009:adverse effects / Q000627:therapeutic use*; D015787:Erythema Chronicum Migrans / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D010146:Pain / Q000139:chemically induced; D011537:Pruritus / Q000139:chemically induced; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D017963:Azithromycin; D004318:Doxycycline