Post by bugsy on Jul 3, 2007 16:00:42 GMT -5
;D
CMDT 2007 Treatment of Lyme.
Antibiotic sensitivity of B burgdorferi has been established in vitro. Tetracycline is effective against the spirochete, but penicillin is only moderately so. Erythromycin is effective in vitro but has been disappointing in clinical trials. Ampicillin, ceftriaxone, azithromycin, cefuroxime, and imipenem are also effective in vitro, but aminoglycosides, ciprofloxacin, and rifampin are not.
Present recommendations for therapy are outlined in Table 34-4
Manifestation Drug & Dosage
Tick bite- No treatment in most circumstances
Erythema migrans- Doxycycline, 100 mg orally twice
Daily, or amoxicillin, 500 mg
Orally three times daily, or
Cefuroxime axetil, 500 mg
Daily-all for 2-3 weeks
Neurologic disease-Bell’s Palsy Doxycycline, or amoxicillin as above
For 2-3 weeks.
Other central nervous
System disease Ceftriaxone, 2 g intravenously
Once daily, or penicillin G, 18-24
Million units daily intravenously in
6 divided doses, or cefotaxime, 2g
Intravenously every 8 hrs all for 2-4
Weeks.
Cardiac disease
First degree block (P-R
<0.3 seconds) Doxycycline or amoxicillin as above
For 2-3 weeks
High Degree atrioventricular
Block Ceftriaxone or penicillin G as above
For 30-60 days
Arthritis oral dosage Doxycycline or amoxicillin as above
For 30-60 days
Acrodermatitis chronicum
Atrophicans Doxycycline or amoxicillin as above
For 4 weeks
Chronic Lyme disease or
Post Lyme disease syndrome symptomatic therapy
~Bugsy
CMDT 2007 Treatment of Lyme.
Antibiotic sensitivity of B burgdorferi has been established in vitro. Tetracycline is effective against the spirochete, but penicillin is only moderately so. Erythromycin is effective in vitro but has been disappointing in clinical trials. Ampicillin, ceftriaxone, azithromycin, cefuroxime, and imipenem are also effective in vitro, but aminoglycosides, ciprofloxacin, and rifampin are not.
Present recommendations for therapy are outlined in Table 34-4
Manifestation Drug & Dosage
Tick bite- No treatment in most circumstances
Erythema migrans- Doxycycline, 100 mg orally twice
Daily, or amoxicillin, 500 mg
Orally three times daily, or
Cefuroxime axetil, 500 mg
Daily-all for 2-3 weeks
Neurologic disease-Bell’s Palsy Doxycycline, or amoxicillin as above
For 2-3 weeks.
Other central nervous
System disease Ceftriaxone, 2 g intravenously
Once daily, or penicillin G, 18-24
Million units daily intravenously in
6 divided doses, or cefotaxime, 2g
Intravenously every 8 hrs all for 2-4
Weeks.
Cardiac disease
First degree block (P-R
<0.3 seconds) Doxycycline or amoxicillin as above
For 2-3 weeks
High Degree atrioventricular
Block Ceftriaxone or penicillin G as above
For 30-60 days
Arthritis oral dosage Doxycycline or amoxicillin as above
For 30-60 days
Acrodermatitis chronicum
Atrophicans Doxycycline or amoxicillin as above
For 4 weeks
Chronic Lyme disease or
Post Lyme disease syndrome symptomatic therapy
~Bugsy