"21. Prompt use of antibiotics
Although no well designed studies have been carried out, the
available data support the prompt use of antibiotics to prevent
chronic Lyme disease. Antibiotic therapy may need to be initiated
upon suspicion of the diagnosis, even without definitive
proof. Neither the optimal antibiotic dose nor the duration of
therapy has been standardized, but limited data suggest a benefit
from increased dosages and longer treatment, comparable to
the data on tuberculosis and leprosy which are caused by similarly
22. Choosing an antibiotic
In acute Lyme disease, the choice of antibiotics should be tailored
to the individual and take into account the severity of the
disease as well as the patient’s age, ability to tolerate side effects,
clinical features, allergy profile, comorbidities, prior exposure,
epidemiologic setting and cost.
Therapy usually starts with oral antibiotics, and some experts
recommend high dosages. The choice of antibiotic therapy is
guided by weighing the greater activity of intravenous antibiotics
in the central nervous system against the lower cost and easy
administration of oral antibiotics for
23. Oral antibiotic options
For many Lyme disease patients, there is no clear advantage of
parenteral therapy. Along with cost considerations and pressure
to treat patients with Lyme disease with the least intervention,
there is growing interest in the use of oral therapy.
First-line drug therapies for Lyme disease may include (in
alphabetical order): oral amoxicillin, azithromycin
These antibiotics have similar favorable results in comparative
trials of early Lyme disease. In one study, azithromycin
performed slightly less well when compared to amoxicillin
and doxycycline. However, the efficacy of azithromycin was
underestimated because the antibiotic was only given for
I've edited out some stuff on late stage disease.
There is growing concern about other vectors for transmitting lyme, and at least two major and similar diseases from the Lone Star tick and a Masteri version that was first found in MO.
Other antibiotics may be substituted for Doxy. DON'T neglect treatment cause you can't tolerate Doxy.
Be proactive with this. If there's one thing I'd stress, it's "don't take a wait and see" approach. Late stage disseminated disease is just miserable to deal with.
Lyme is a spirochete and goes deep tissue. Since it can affect multiple body systems. it's not surprising it can look like Fibro or Chronic Fatigue. Just my opinion - some cases of Fibro may be undiagnosed Lyme, but Fibro exists and is a distinct condition. With enough research, maybe we'll be able to understand all the interactions of multiple body systems that produce Fibro.