TREATMENT OF LATE LYME BORRELIOSIS

The aim of this study was to develop a treatment for late Lyme borreli osis and to compare the clinical results with serological findings bef ore and after treatment. It was done in the Aland Islands (population 25 000), a region endemic for Lyme borreliosis. The patients were the first consecutive 100 patients from the Aland Islands with late Lyme b orreliosis. They were followed for at least 1 year after treatment. Th e clinical results of treatment were compared with results of analyses of flagellar IgG antibodies to Borrelia burgdorferi done at the time of diagnosis before treatment and up to It months afterwards. Short pe riods of treatment were not generally effective. The outcome was succe ssful in four of 13 treatments with 4 days of intravenous ceftriaxone alone, in 50 of 56 assessable treatments with ceftriaxone followed by 100 days of amoxycillin plus probenecid, and in 19 of 23 completed tre atments with ceftriaxone followed by 100 days of cephadroxil. Titres o f IgG antibodies to B. burgdorferi flagella declined significantly aft er 6 and 2 months in the patients who had successful treatments. All p atients whose final titres were less than 30 % of the initial titre we re in the successful group. Their titres usually remained above the up per limit of normal for a long time but a decline to a value of less t han 30 % of that before treatment was always a sign of cure.