Long-term use of antibiotics to treat symptoms of Lyme disease yields no greater benefits than treating it short-terms with the drugs, a study has revealed.
In Europe’s first double-blind randomised study to examine the effects of antibiotics on chronic Lyme symptoms, no clear benefits were recorded by those who were prescribed the drugs for a long period.
The PLEASE study, undertaken by Radboud University medical centre, in the Netherlands, followed 280 patients, all of whom had been previously diagnosed with the disease and had symptoms such as muscle and joint pain, fatigue and concentration problems.
Writing in the 30 March edition of New England Journal of Medicine, Professor Bart Jan Kullberg, professor of medicine and infectious diseases, describes how all participants were prescribed ceftriaxon for the first two weeks.
Afterwards, they were randomly divided into three groups: the first was given doxycycline for 12 weeks, the second had a combination of clarithromycin and hydroxychloroquine, while the third group was given a placebo.
Before and after treatment, the participants completed questionnaires about their symptoms, their fitness level, quality of life and wellbeing. They repeated the questionnaires after 26, 40 and 52 weeks and took memory tests and used a pedometer to record their movement.
The researchers found no clear differences between the three groups.
“Longer treatment is required for some forms of Lyme disease,” said Prof Kullberg. “However, based on the results reported by the participants themselves, we must conclude that long-term use of antibiotics does not help patients who previously had Lyme disease and continue to report unexplained, persistent symptoms. These patients need customised care, not just a prescription for antibiotics.”
Anneleen Berende A, ter Hofstede H, Vos F et al. Randomized Trial of Longer-Term Therapy for Symptoms Attributed to Lyme Disease. New England Journal of Medicine 30 March, 2016.
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