Treatment and prevention of Lyme disease, with emphasis on antimicrobial therapy for neuroborreliosis and vaccination

Seminars in Neurology
G P Wormser

Abstract

Antibiotic therapy is recommended for all forms of neuroborreliosis. Although stage 2 neuroborreliosis will usually resolve without any treatment, antibiotic therapy has been associated with faster resolution of symptoms and may prevent additional non-neurologic disease manifestations. Ceftriaxone is the most convenient parenteral agent for stage 2 and 3 neuroborreliosis because of its once-daily dosage. Available data indicate that a 2-4-week treatment course is adequate for most patients. Patients with isolated seventh nerve palsy may be treated with an oral agent (for example, doxycycline). Recombinant outer surface protein A of Borrelia burgdorferi is a highly protective immunogen for prevention of Lyme disease in experimental animals. Humoral immunity is sufficient for protection. A recombinant OspA vaccine has been licensed for prevention of Lyme disease in dogs. Licensure of an OspA vaccine for humans will depend on a critical analysis of the results of recently completed efficacy studies.

Citations

Aug 26, 1998·Lancet·R B Nadelman, G P Wormser
Oct 10, 2006·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Gary P WormserRobert B Nadelman
May 26, 1999·Annals of Emergency Medicine·J A Edlow
Sep 12, 2015·Journal of Clinical Apheresis·Tamer ÇelikDinçer Yıldızdas
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May 5, 2001·Expert Opinion on Pharmacotherapy·J Ravishankar, L I Lutwick
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Jun 5, 2003·Expert Opinion on Investigational Drugs·Charles S Pavia
May 18, 2012·The Pediatric Infectious Disease Journal·Amy D ThompsonLise E Nigrovic

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