Oral doxycycline versus intravenous ceftriaxone for European Lyme neuroborreliosis: a multicentre, non-inferiority, double-blind, randomised trial
Unn Lj�stad MD email address a Corresponding Author Information, Eirik Skogvoll PhD b, Randi Eikeland MD c, Rune Midgard PhD d, Tone Skarpaas MD e, �se Berg MD f and �se Mygland PhD a g h Summary Background
Use of intravenous penicillin and ceftriaxone to treat Lyme neuroborreliosis is well documented, although oral doxycycline could be a cost-effective alternative. We aimed to compare the efficacy of oral doxycycline with intravenous ceftriaxone for the treatment of Lyme neuroborreliosis. Methods
From April, 2004, to October, 2007, we recruited consecutive adult patients from nine hospitals in southern Norway into a non-inferiority trial. Inclusion criteria were neurological symptoms suggestive of Lyme neuroborreliosis without other obvious causes, and presence of any of the following: a CSF white-cell count of more than five per mL; intrathecal production of specific Borrelia burgdorferi antibodies; or acrodermatitis chronicum atrophicans. Patients were randomly allocated to receive 200 mg oral doxycycline or 2 g intravenous ceftriaxone once per day for 14 days, in a double-blind, double-dummy design. A composite clinical score (range 0 to 64, 0=best) was based on standardised interviews and clinical neurological examination. The primary outcome was reduction in clinical score at 4 months after the start of treatment. Analysis was per protocol. This trial is registered with ClinicalTrials.gov, number NCT00138801. Findings
Of 118 patients who underwent randomisation, 102 completed the study (mean clinical score at baseline 8�5 [SD 4�1]). 4 months after the start of treatment, mean score improvement in the doxycycline group (n=54) was 4�5 (95% CI 3�6 to 5�5) points and that in the ceftriaxone group (n=48) was 4�4 (3�4 to 5�4) points (95% CI for difference between groups −0�9 to 1�1; p=0�84). 26 (48%) patients in the doxycycline group and 16 (33%) in the ceftriaxone group had total recovery (95% CI for difference between groups −4% to 34%; p=0�13). Side-effects possibly related to treatment were reported in 21 (37%) and 26 (46%) patients in these groups, respectively (−28% to 9%; p=0�30). Three patients discontinued ceftriaxone treatment owing to adverse events. Interpretation
Oral doxycycline is as efficient as intravenous ceftriaxone for the treatment of European adults with Lyme neuroborreliosis.
Posted by bettyg (Member # 6147) on :
durham,
could you break this up galore since it's ALL TECHINICAL? thx
make the tech stuff is shorter since there were all these numbers involved, and we just can NOT process them as is ok .... big thanks!! xox
When you post or reply, please break up your solid, continuous block text
welcome to the board! many of us have neuro lyme where we can NOT read long solid block text and be able to comprehend and read it as is.
please edit your post by CLICKING PAPER/PENCIL ICON to right of your name. that opens up BOTH subject line and body text.
now please break up your WORDY SENTENCES into one sentence paragraphs. Then hit ENTER KEY ``THREE`` after each paragraph; we need that space for comprehension.
if you are NOT a wordy person, you can do 2 or 3 total ok. do this for your entire post.
then go to left hand corner and mark box to receive ALL REPLIES, and click EDIT SEND
we thank you for helping us; otherwise, we will SOB, SCROLL ON BY, since we can't read to help you. If I see posts like this, I SOB them; to hard on me. I'm also in the early stages of losing my eyesight from diabetes retinopathy. Posted by sparkle7 (Member # 10397) on :
People who take abx usually take them for much longer than 14 days. It didn't say if these people had "chronic" Lyme, either (& how long they were ill for).
The study wasn't long enough to prove anything & I'm not big on abx in any case. The findings aren't all that informative.
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otherwise, we will SOB, SCROLL ON BY, since we can't read to help you. If I see posts like this, I SOB them; to hard on me. I'm also in the early stages of losing my eyesight from diabetes retinopathy. ![[Frown]](frown.gif)