0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

Antibiotic Therapy in Lyme Disease

ALLEN C. STEERE, M.D.; STEPHEN E. MALAWISTA, M.D.; JAMES H. NEWMAN, M.D.; PHYLLIS N. SPIELER, M.D.; and NICHOLAS H. BARTENHAGEN, M.D.
[+] Article and Author Information

Grant support: in part by U.S. Public Health Service Grants AM-20358, AM-10493, AM-07107, AM-5639, RR-05443, and RR-00125; the Arthritis Foundation and its Connecticut Chapter; and the Kroc Foundation of Santa Ynez, California.

▸Requests for reprints should be addressed to Allen C. Steere, M.D.; Department of Internal Medicine, Yale University School of Medicine, 333 Cedar Street; New Haven, CT 06510.


New Haven, Connecticut


© 1980 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1980;93(1_Part_1):1-8. doi:10.7326/0003-4819-93-1-1
Text Size: A A A

We studied antibiotic efficacy in 113 patients with erythema chronicum migrans, the first manifestation of Lyme disease. Erythema chronicum migrans and its associated symptoms resolved faster in patients given penicillin or tetracycline (median duration, 4 and 2 days, respectively) than in untreated patients (10 days; P < 0.001 and P = 0.005, respectively). Erythromycin had no significant effect. Although the frequency of subsequent neurologic and cardiac abnormalities was similar in all four groups, significantly fewer patients given penicillin developed arthritis than did untreated patients (P = 0.001). Among 15 patients with arthritis who were followed for at least 29 months, the total duration of joint involvement was shorter in penicillin-treated patients (median, 4 weeks) than in untreated patients (17 weeks; P = 0.019). Although the clinical manifestations of the disease may fluctuate in frequency from year to year and influence apparent antibiotic effect, we conclude that penicillin therapy shortens the duration of erythema chronicum migrans and may prevent or attenuate subsequent arthritis.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Journal Club
Related Point of Care
Topic Collections
PubMed Articles
Bullous Lyme disease. J Am Acad Dermatol 2014;71(4):e133-4.
Is there a place for xenodiagnosis in the clinic? Expert Rev Anti Infect Ther 2014;12(11):1307-10.
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)