Examples
|
| amoxicillin | |
| cefotaxime | Claforan |
| ceftriaxone | Rocephin |
| cefuroxime | Ceftin |
| doxycycline | Doryx, Vibramycin, Vibra-Tabs |
| erythromycin | Erythrocin, Ery-Tab |
| penicillin | |
| tetracycline | Sumycin |
How It Works
These drugs kill Borrelia burgdorferi bacteria, which cause
Lyme disease.
Why It Is Used
Antibiotics are used to cure early
Lyme disease and to greatly reduce the risk of future complications.
Antibiotics may also be used in the later
stages of Lyme disease, when additional symptoms
involving the skin, joints, nervous system, or heart may develop.
The type of antibiotic prescribed depends on your age, symptoms, and
stage of Lyme disease. These medicines may be taken orally, as an injection, or
through a vein (intravenous, or IV). The length of antibiotic
treatment varies according to how bad the disease and your symptoms are, but
treatment generally lasts less than 4 weeks.
Early Lyme disease
- For people ages 8 and older, the number of
days the antibiotic is used depends on the antibiotic and the severity of the
infection.
- Doxycycline should not be used to treat pregnant women
or children younger than age 8.
- For children younger than age 8,
amoxicillin is taken by mouth. Other medicines may be
used if the child is allergic to amoxicillin.
Later stages of Lyme disease
- For
Lyme arthritis, oral antibiotics are usually taken for
several weeks. If treatment with the oral antibiotic is not successful, an
antibiotic may be given intravenously (IV).
- For facial paralysis with no other
nervous system problems, an oral antibiotic for
several weeks is usually effective.
- For severe heart symptoms of
Lyme disease or for other Lyme disease nervous system problems such as Lyme
meningitis, IV antibiotics may be given.
Pregnant or nursing women
- Women who have early Lyme disease usually
take an oral antibiotic for several weeks. Some doctors believe that pregnant
women with early Lyme disease should receive IV antibiotics to prevent Lyme
disease bacteria from crossing the protective membrane (placenta) that
surrounds the developing fetus. But there is no proof such treatment is
needed.
- In pregnant or nursing women who have late Lyme disease, IV
antibiotics usually are used.
How Well It Works
Antibiotics are most effective in
helping cure Lyme disease when they are taken early in the course of the
disease.1 Early treatment with antibiotics can help
prevent future problems with arthritis, the heart, or the nervous system. But
symptoms may not go away right away. Some symptoms may last for several weeks
after treatment. This does not mean that the antibiotics were not successful,
nor does it mean that you need additional antibiotic treatment.
Antibiotic treatment for early symptoms of
chronic Lyme arthritis is usually very effective.
Joints that have been badly damaged by Lyme arthritis may take a long time to
get better after the infection has been cured, or they may not respond to
treatment at all. A small percentage of people in the United States continue to have
symptoms of chronic Lyme arthritis after treatment with antibiotics.2
Heart symptoms often begin to go away before
antibiotics are given. If not, they usually respond to antibiotic therapy
within days. Mild heart symptoms that may occur with early Lyme disease usually
improve after treatment with oral amoxicillin or doxycycline for 21 to 30
days.
Symptoms of
inflammation of the membrane surrounding the brain and
spinal cord (Lyme
meningitis) begin to improve by the second day of
therapy and usually disappear after 7 to 10 days.
Side Effects
Common side effects of these antibiotics
include:
- Nausea.
- Mild
diarrhea.
- Allergic reaction.
- Secondary yeast infection
in the intestines, vagina, or mouth (thrush).
Some people treated for early Lyme disease have brief
episodes of headache, muscle and joint pain, and fatigue that may continue for
an extended period of time after treatment. These symptoms usually go away on
their own within 6 months and do not require further treatment.
During the first 24 hours of antibiotic therapy, you may have a higher
fever, redder rash, or greater pain. This is not an allergic reaction to the
drug. It may mean that the bacteria are rapidly dying.
One large
study suggests that people who take erythromycin along with certain common
medicines may raise their risk of sudden cardiac death.3 The study showed that the risk of sudden cardiac death is
greater when erythromycin is taken with some medicines that inhibit certain
liver enzymes—such as certain calcium channel blockers, certain antifungal
medicines, and some antidepressants—than when these medicines are not taken
together.
See Drug Reference for a full list of side effects.
(Drug Reference is not available in all systems.)
What To Think About
The dosage of antibiotic given and
the duration of treatment should be based on your age and body weight, how bad
the illness is, and how you respond to treatment.
Doxycycline
should be taken with plenty of fluids and not while you are lying down or right
before bedtime.
If you get
intravenous (IV) antibiotics, you may have weekly
blood tests to check your white blood cell count. The IV antibiotic treatment
may lead to low levels of white blood cells (called leukopenia) that can make
it hard for you to fight infection.
With the exception of pregnant
women and people with severe arthritis or heart problems, most people who have
been exposed to ticks but do not have symptoms are not given antibiotics. Even
in parts of the country where Lyme disease is known to occur often, the risk of
getting Lyme disease is too small to warrant treatment before symptoms
appear.
Doxycycline is the drug of choice for treating early Lyme
disease in people ages 8 and older. But it should not be given to pregnant
women or to people who are allergic to tetracycline.
Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.
References
Citations
- Sharma SK, Kadhiravan T (2009). Lyme disease. In RE Rakel, ET Bope, eds., Conn's Current Therapy 2009, pp. 136–139. Philadelphia: Elsevier Saunders.
- Steere AC (2010). Borrelia burgdorferi (Lyme Disease, Lyme Borreliosis). In GL Mandell et al., eds., Principles and Practices of Infectious Diseases, 7th ed., chap. 239, pp. 3071–3081. Philadelphia: Elsevier Churchill Livingstone.
- Ray WA, et al. (2004). Oral erythromycin and the risk
of sudden death from cardiac causes. New England Journal of Medicine, 351(11): 1089–1096.
Credits
| By | Healthwise Staff |
|---|
| Primary Medical Reviewer | E. Gregory Thompson, MD - Internal Medicine |
|---|
| Specialist Medical Reviewer | Christine Hahn, MD - Epidemiology |
|---|
| Last Revised | May 9, 2011 |
|---|
Sharma SK, Kadhiravan T (2009). Lyme disease. In RE Rakel, ET Bope, eds., Conn's Current Therapy 2009, pp. 136–139. Philadelphia: Elsevier Saunders.
Steere AC (2010). Borrelia burgdorferi (Lyme Disease, Lyme Borreliosis). In GL Mandell et al., eds., Principles and Practices of Infectious Diseases, 7th ed., chap. 239, pp. 3071–3081. Philadelphia: Elsevier Churchill Livingstone.
Ray WA, et al. (2004). Oral erythromycin and the risk
of sudden death from cardiac causes. New England Journal of Medicine, 351(11): 1089–1096.
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