Infection: Lyme disease

Question 1

What are the antibacterials of choice for early lyme disease or lyme arthritis?

Answer 1

Doxycycline, amoxicillin [unlicensed indication] or cefuroxime (as cefuroxime axetil) are the antibacterials of choice for early Lyme disease or Lyme arthritis.

Question 2

If amoxicillin [unlicensed] or cefuroxime are contra-indicated for the treatment of early lyme disease or lyme arthritis, what can be used?

Answer 2

If these antibacterials are contra-indicated, a macrolide (e.g. clarithromycin) can be used for early Lyme disease. Intravenous administration of ceftriaxone, cefotaxime, or benzylpenicillin sodium is recommended for Lyme disease associated with cardiac or neurological complications. The duration of treatment is usually 2–4 weeks; Lyme arthritis may require further treatment.

Question 3

What is the recommended treatment for lyme disease associated with cardiac or neurological complications?

Answer 3

Intravenous administration of ceftriaxone, cefotaxime, or benzylpenicillin sodium is recommended for Lyme disease associated with cardiac or neurological complications. The duration of treatment is usually 2–4 weeks; Lyme arthritis may require further treatment.