Lyme disease definitely constitutes a therapeutic challenge. There has
been conflicting evidence as far as the successful use of macrolides
in this context is concerned. Acithromycin, however, has been unanimou
sly reported as successful in early stages of Lyme disease, whereas le
ss convincing evidence has been presented for erythromycin and roxithr
omycin. The latter has received some attention when combined with co-t
rimoxazole as a strategy in late Lyme disease refractory to convention
al therapy. In summary, macrolides are potent anti-Borrelia agents but
certainly require further investigation.