savebabe
Frequent Contributor (1K+ posts)
Member # 9847
posted
This information was given to me by Dr. B before he retired.
Lyme Disease and Pregnancy
It is well known that B. burdorferi, the agent of lyme, can cross the placenta and infect the fetus. In addition, breast milk from infected mothers has been shown to harbor spirochetes that can be detected by PCR and grown in culture.
The Lyme Disease Foundation in Hartford, Ct had kept a pregnancy registry since the late 1980's. They found that if patients were maintained on adequate doses of antibiotic therapy during gestation, then no babies were born with Lyme. My own experience over the last ten years agrees with this.
Dr. J, a pediatrician who practices in Connecticut, has treated and kept records on literally hundreds of babies born with Lyme Disease, having contracted it as an intrauterine infection. He treats theses children with antibiotics and finds that they generally do well, provided that treatment is aggressive and of adequated duration. Occassionally, he has to retreat theses patients as lyme infections are chronic and can tend to recur.
The options for treating the mother include, oral, intramuscular and intravenous therapy.
Oral regimens include amoxicillin, 1000 mg every 6 hours, and cefuroxime axetil 1000 mg every 12 hours with food. We always document peak and through serum levels at the start of gestation and at least once more during tratment. We like to see a peak level above 10, with a through at least 3. These level apply for either medication.
For patients wo are very ill, or in those who cannot tolerate oral medications or achieve adequate level, then parenteral therapy is given. Choices include benzathine penicillin (bicillin LA) 1.2 milllion units IM three times per week. Intravenous can inclue ceftriaxone, 2 g IV daily, or cefatoxime, 6 g daily either as a continuious infusion or as 2 G IV q 8h.
During pregnancy, symptoms generally are mild as the hormonal changes seem to mask many sympotms. However, post-partum, mothers have a rough time, with a sudden return of all their lyme symptoms including profound fatigue. We advise against breast feeding for obvious reasons as mentioned above, and we always advise help in the home for at least the first month, so adequate rest and time for needed treatment are assure.
Posts: 1603 | From ny | Registered: Aug 2006
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bettyg
Unregistered
posted
babe, thx for posting this; i added it to my newbie's links.
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thanks for the info! Do you know when you are to start antibx during pg? When I was a pt of Dr. B's I thought he said the whole time. Now I am with a LLMD that says start antibx after first trimester. Anyone know?? Thanks!
Posts: 117 | From Chicago, IL | Registered: Jan 2006
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savebabe
Frequent Contributor (1K+ posts)
Member # 9847
posted
Dr. B told me the whole time you are pregnant you should be on abx.
If you are trying to become pregnant, I believe he recommended that you start bicillin shots 2 weeks prior to ovulation.
Posts: 1603 | From ny | Registered: Aug 2006
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