Ceftriaxone Compared with Doxycycline for the Treatment of Acute Disseminated Lyme Disease
| Autor: | Gary P. Wormser, William A. Agger, Benjamin J. Luft, Raymond J. Dattwyler, Edgar Grunwaldt, Mark J. Kunkel, D. Maladorno, Donald Oswald, Louise Cockey, Michael F. Finkel, Thomas J. Rush, Michael Franklin |
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| Rok vydání: | 1997 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Administration Oral Injections Intramuscular Lyme disease medicine Humans Disseminated disease Prospective Studies Borrelia burgdorferi Child Aged Aged 80 and over Doxycycline Lyme Disease biology business.industry Ceftriaxone Borrelia Burgdorferi Infection General Medicine Middle Aged medicine.disease biology.organism_classification Dermatology Anti-Bacterial Agents Cephalosporins Surgery Treatment Outcome Acute Disease Injections Intravenous Erythema chronicum migrans Erythema migrans Female medicine.symptom business medicine.drug |
| Zdroj: | New England Journal of Medicine. 337:289-295 |
| ISSN: | 1533-4406 0028-4793 |
| DOI: | 10.1056/nejm199707313370501 |
| Popis: | Localized Lyme disease, manifested by erythema migrans, is usually treated with oral doxycycline or amoxicillin. Whether acute disseminated Borrelia burgdorferi infection should be treated differently from localized infection is unknown.We conducted a prospective, open-label, randomized, multicenter study comparing parenteral ceftriaxone (2 g once daily for 14 days) with oral doxycycline (100 mg twice daily for 21 days) in patients with acute disseminated B. burgdorferi infection but without meningitis. The erythema migrans skin lesion was required for study entry, and disseminated disease had to be indicated by either multiple erythema migrans lesions or objective evidence of organ involvement.Of 140 patients enrolled, 133 had multiple erythema migrans lesions. Both treatments were highly effective. Rates of clinical cure at the last evaluation were similar among the patients treated with ceftriaxone (85 percent) and those treated with doxycycline (88 percent); treatment was considered to have failed in only one patient in each group. Among patients whose infections were cured, 18 of 67 patients in the ceftriaxone group (27 percent) reported one or more residual symptoms at the last follow-up visit, as did 10 of 71 patients in the doxycycline group (14 percent, Por = 0.05). Mild arthralgia was the most common persistent symptom. Both regimens were well tolerated; only four patients (6 percent) in each group withdrew because of adverse events.In patients with acute disseminated Lyme disease but without meningitis, oral doxycycline and parenterally administered ceftriaxone were equally effective in preventing the late manifestations of disease. |
| Databáze: | OpenAIRE |
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