Are antibiotics used to treat Lyme disease effective?

An article entitled “Antibiotic treatment in patients that present with solely non-specific symptoms and positive serology at a Lyme centre,” published in the European Journal of Internal Medicine, ¹ describes a study which addresses the question: Are short-term antibiotics used to treat Lyme disease effective in patients whose symptoms are subjective?

The study examined 97 patients who presented with non-specific symptoms and had no previous treatment for Lyme disease but were positive by immunoglobulin G (IgG) serology tests.

“Non-specific” symptoms included:

• Myalgia/arthralgia
• Fatigue (includes lethargy and loss of energy)
• Sleep disturbances
• Headache
• Inflammatory symptoms (includes fever, temperature rise, sore throat, and night sweats)
• Cognitive disorder
• Sensory disorder
• Digestive disorder
• Dizziness/lightheadedness
• Shortness of breath/palpitations
• Mood disorder

Researchers looked at whether these patients would benefit from antibiotics used to treat Lyme disease and whether certain patient characteristics contributed to treatment success.

Study results

They found that nearly 50% of patients “had a clear or intermediate effect from antibiotic treatment.”

Most of the 97 patients were adults. Over 70% were men. And, the non-specific symptoms had been present for an average of 2 years.

Doxycycline was one of the antibiotics used to treat Lyme disease. The remaining patients received amoxicillin. A 4-week course was prescribed to most of the patients. Interestingly, patients with inflammatory symptoms benefited the most from doxycycline.

[bctt tweet=”Does a short course of antibiotics help Lyme disease patients who have non-specific symptoms, like fatigue, mood disturbances and sleep disturbances?” username=”DrDanielCameron”]

Furthermore, “patients with symptoms suggestive for inflammatory disease and patients with the IgG immunoblot antigen p58 benefited significantly more often from antibiotic treatment compared to patients without these characteristics,” the authors point out.

Of the 97 patients who improved with antibiotics, 15.5% had a clear effect from antibiotic treatment, while 26.8% had an intermediate effect and 50.5% experienced no effect.

Authors conclude

“This study shows that antibiotics possibly have an effect on non-specific symptoms in previously untreated patients with positive Borrelia serology,” the authors conclude.

“However, these beneficial effects were intermediate in a considerable amount of patients.”

The authors suggest, an RCT [randomized clinical trial] “is needed to validate our findings, relevant for clinicians in Lyme centres.”

They also point out that an improvement of symptoms may have been the result of eradicating another pathogen and not Borrelia burgdorferi, the causative agent of Lyme disease.

“Symptoms suggestive for inflammatory disease were associated with treatment effect. This could indicate an effect of antibiotic treatment on pathogens related to diseases other than LB [Lyme borreliosis].”

Studies dispute antibiotic benefits

Meanwhile, findings from the Klempner clinical trial, sponsored by the National Institutes of Health (NIH), suggest that antibiotics used to treat Lyme disease would not be beneficial to patients with non-specific symptoms.²

However, that trial enrolled patients who had been ill an average of 4.7 years and who had already failed an average of 2 treatments.

Another trial, also sponsored by the NIH, found that antibiotics would be helpful but only for Lyme disease patients suffering from fatigue and not for other non-specific symptoms.³

Editor’s Note:

The study featured in the European Journal of Internal Medicine has several limitations. Treatment effectiveness may have been due to a pathogen other than Lyme disease. And there was no controlled study population.

That said, the results should encourage additional research on the benefits of antibiotics used to treat Lyme disease patients who suffer from non-specific symptoms.