AZITHROMYCIN VERSUS DOXYCYCLINE FOR TREATMENT OF ERYTHEMA MIGRANS - CLINICAL AND MICROBIOLOGICAL FINDINGS

The effectiveness of azithromycin an doxycycline in the treatment of e rythema migrans was compared in a prospective randomized trial. One hu ndred seven adult patients with typical erythema migrans, examined in the Lyme Borreliosis Outpatients' Clinic, University Department of Inf ectious Diseases in Ljubljana, were included in the study. Fifty-five patients received azithromycin (500 mg twice daily for the first day, followed by 500 mg once daily for four days) and 52 patients received doxycycline (100 mg twice daily for 14 days). The mean duration of ski n lesions after the beginning of treatment was 7.5 +/- 5.9 days (media n value 5, range 2-28 days) in the azithromycin group and 11.4 +/- 7.8 days (median value 9, range 2 days - 8 weeks) in the doxycycline grou p (p < 0.05). Borrelia burgdorferi was isolated from erythema migrans in 28 patients before therapy: in 13 out of 52 in the doxycycline grou p and in 15 out of 55 in the azithromycin group. Three months after th erapy, the culture was positive in four out of 13 patients treated wit h doxycycline and in one of the 15 patients who received azithromycin. A biopsy was repeated in all the patients with a positive isolation f rom the first skin specimen. During the first 12 months' follow-up, th ree patients treated with doxycycline but none in -the azithromycin gr oup developed major manifestations of Lyme borreliosis, while 15 doxyc ycline recipients and 10 azithromycin recipients developed minor conse cutive manifestations.