TREATMENT OF LYME ARTHRITIS

The efficacy of different therapeutic regimens for Lyme arthritis is r eviewed, The first treatment for Lyme arthritis, intramuscular benzath ine penicillin 2.4 million units weekly for 3 weeks, had a success rat e of 35%, Another study employed intravenous penicillin G at a dosage of 20 million units daily for 10 days, which cured 55% of patients, In travenous ceftriaxone has been shown to be superior to penicillin with a response rate of 94%. However, these results have been challenged i n recent reports. Oral doxycycline or amoxicillin in association with probenecid seems to work equally well although neuroborreliosis was mo re frequent following treatment with amoxicillin. An anecdotal report indicates the usefullness of long-term benzathine penicillin for chron ic Lyme arthritis, Longterm antibiotic therapy, which is recommended a lso for Reiter's syndrome, may be useful for eradicating the sanctuari es of Borrelia burgdorferi. Disease-modifying drugs such as hydroxychl oroquine or sulphasalazine, a drug which is commonly used in reactive arthritis following enteric infections, may be of value in Lyme arthri tis resistant to antibiotics but have not been tested to date, The rol e of intraarticular injections of steroids or synovectomy is still con troversial, Antibiotic treatment is the cornerstone of Lyme arthritis treatment, Additional interventions should be studied for patients wit h Lyme arthritis resistant to antibiotics.