Clinical Infectious Disease

Clinical Infectious Disease

Clinical Infectious Disease

Counterpoint: Long-Term Antibiotic Therapy Improves Persistent
Symptoms
Associated with Lyme Disease

Raphael B. Stricker

Volume 45(2007), pages 149 - 157
DOI: 10.1086/518853

Abstract

Background. Controversy exists regarding the diagnosis and treatment
of
Lyme disease. Patients with persistent symptoms after standard (2
[ndash] 4-week) antibiotic therapy for this tickborne illness have
been
denied further antibiotic treatment as a result of the perception that
long-term infection with the Lyme spirochete, Borrelia burgdorferi,
and
associated tickborne pathogens is rare or nonexistent.

Methods. I review the pathophysiology of B. burgdorferi infection and
the peer-reviewed literature on diagnostic Lyme disease testing,
standard treatment results, and coinfection with tickborne agents,
such
as Babesia, Anaplasma, Ehrlichia, and Bartonella species. I also
examine
uncontrolled and controlled trials of prolonged antibiotic therapy in
patients with persistent symptoms of Lyme disease.

Results. The complex "stealth" pathology of B. burgdorferi allows the
spirochete to invade diverse tissues, elude the immune response, and
establish long-term infection. Commercial testing for Lyme disease is
highly specific but relatively insensitive, especially during the
later
stages of disease. Numerous studies have documented the failure of
standard antibiotic therapy in patients with Lyme disease. Previous
uncontrolled trials and recent placebo-controlled trials suggest that
prolonged antibiotic therapy (duration, >4 weeks) may be beneficial
for
patients with persistent Lyme disease symptoms. Tickborne coinfections
may increase the severity and duration of infection with B.
burgdorferi.

Conclusions. Prolonged antibiotic therapy may be useful and
justifiable
in patients with persistent symptoms of Lyme disease and coinfection
with tickborne gents.

Re: Clinical Infectious Disease

On May 19, 8:55 pm, lipanz <lipanzmari...@aol,com > wrote:
> Clinical Infectious Disease
>
> Counterpoint: Long-Term Antibiotic Therapy Improves Persistent
> Symptoms
> Associated with Lyme Disease
>
> Raphael B. Stricker
>
Stricker?

I heard he's Dr. "Big"...

Re: Clinical Infectious Disease

On May 19, 11:18=EF=BF=BDpm, the 3rd Man <sir_de...@yahoo,com > wrote:
> On May 19, 8:55=EF=BF=BDpm, lipanz <lipanzmari...@aol,com > wrote:> Clinica=
l Infectious Disease
>
> > Counterpoint: Long-Term Antibiotic Therapy Improves Persistent
> > Symptoms
> > Associated with Lyme Disease
>
> > Raphael B. Stricker
>
> Stricker?
>
> I heard he's Dr. "Big"...

FUNNY-HO HO

Re: Clinical Infectious Disease

On May 19, 10:24=C2=A0pm, lipanz <lipanzmari...@aol,com > wrote:
> On May 19, 11:18=EF=BF=BDpm, the 3rd Man <sir_de...@yahoo,com > wrote:
>
> > On May 19, 8:55=EF=BF=BDpm, lipanz <lipanzmari...@aol,com > wrote:> Clini=
cal Infectious Disease
>
> > > Counterpoint: Long-Term Antibiotic Therapy Improves Persistent
> > > Symptoms
> > > Associated with Lyme Disease
>
> > > Raphael B. Stricker
>
> > Stricker?
>
> > I heard he's Dr. "Big"...
>
> FUNNY-HO HO

I just meant that he is one of the more prominent MEMBERS of ILADS.

That's all.

No need to go and make a big, hairy deal of it...