Comparison of a two- or three-week regimen and a review of treatment of erythema migrans with phenoxymethylpenicillin.
BACKGROUND
A longer duration treatment is preferred in erythema migrans (EM) to prevent late complaints.


OBJECTIVE
To determine whether 20 (20d-pt) or 14 days (14d-pt) of phenoxymethylpenicillin (PenV) have similar efficacy in treating EM and preventing further sequelae.


METHODS
In a prospective double-centre study, 102 patients with EM were treated with PenV 1.5 million IU thrice daily for either 20 or 14 days and followed up for 12 months.


RESULTS
The primary cure rate after treatment with PenV was 91.5% (79.6-97.6) for 20d-pt vs. 91.7% (77.5-98.2) for 14d-pt; p > 0.99). In 7 patients (4/20d-pt and 3/14d-pt), persistent or newly arising symptoms required retreatment. After 1 year, all patients were cured. The immune response showed no statistical difference between the treatment groups in the follow-up period.


CONCLUSIONS
A 2-week treatment regimen of PenV seems to be as effective as a 3-week course with no statistical differences for clinical and serological findings after treatment.
Department of Dermatology, Medical University of Graz, Auenbruggerplatz 8, AT-8036 Graz, Austria. elisabeth.aberer@meduni-graz.at
E
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Aberer
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Kahofer
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Binder
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Kinaciyan
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Schauperl
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Berghold
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000888:Antibodies, Anti-Idiotypic / Q000276:immunology; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004797:Enzyme-Linked Immunosorbent Assay; D004890:Erythema / Q000188:drug therapy* / Q000276:immunology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology; D007075:Immunoglobulin M / Q000276:immunology; D008297:Male; D008875:Middle Aged; D010404:Penicillin V / Q000008:administration & dosage / Q000627:therapeutic use*; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000888:Antibodies, Anti-Idiotypic; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D010404:Penicillin V