COMPARISON OF INTRAVENOUS PENICILLIN-G AND ORAL DOXYCYCLINE FOR TREATMENT OF LYME NEUROBORRELIOSIS

To compare the efficacy of oral doxycycline and IV penicillin G for th e treatment of neuroborreliosis, we randomized consecutive patients wi th Lyme neuroborreliosis to receive either. IV penicillin G (3 g q 6 h ) or oral doxycycline (200 mg q 24 h) for 14 days. All patients had an tibodies against Borrelia burgdorferi in serum, CSF, or both, or had a positive CSF culture. Twenty-three patients randomized to penicillin G and 31 patients to doxycycline were included in the study. All patie nts improved during treatment, and there were no significant differenc es between the two treatment groups in patient scoring, CSF analysis, or serologic and clinical follow-up during 1 year. There were no treat ment failures, although one patient in each treatment group was re-tre ated because of residual symptoms. In conclusion, oral doxycycline is an adequate and cost-effective alternative to IV penicillin for the tr eatment of Lyme neuroborreliosis.