July 1, 1983Annals of Internal Medicine
Treatment of the Early Manifestations of Lyme Disease
Authors
Discussion
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Implication
Clinical trial reveals faster symptom resolution and fewer late complications with tetracycline in early Lyme disease, indicating its superior therapeutic efficacy.
Key Points
- To compare the efficacy of penicillin, tetracycline, and erythromycin in resolving acute symptoms and preventing major late complications in early Lyme disease.
- Evaluated 108 adult patients with early Lyme disease treated with penicillin (N=40), tetracycline (N=39), or erythromycin (N=29) during 1980–1981.
- Treated an additional cohort of 49 adult patients exclusively with tetracycline in 1982.
- Assessed time to resolution of erythema chronicum migrans, occurrence of major late complications (meningoencephalitis, myocarditis, recurrent arthritis), and minor late symptoms.
- Erythema chronicum migrans and associated symptoms resolved faster with penicillin (mean 5.4 days) and tetracycline (mean 5.7 days) compared to erythromycin (mean 9.2 days, F=3.38, p<0.05).
- Major late complications occurred in 0 of 39 tetracycline-treated patients compared with 3 of 40 penicillin-treated and 4 of 29 erythromycin-treated patients (chi-square=5.33, p=0.07); 0 of 49 patients treated with tetracycline in 1982 developed major complications.
- Minor late symptoms (headache, musculoskeletal pain, lethargy) occurred in nearly half of patients across all treatment groups and correlated with initial illness severity.
Cite This Study
Allen C. Steere (1983) studied this question.