It’s important to get a diagnosis and treatment as soon as possible, before more severe Lyme disease symptoms develop. After you remove a deer tick that has been attached to you for at least 36 hours — the amount of time it takes for the tick to transmit the bacteria Borrelia burgdorferi — there’s a 72-hour window during which your doctor may give you a single dose of the antibiotic doxycycline to prevent the development of Lyme disease. (1) Doxycycline is prescribed to patients age 8 and older, except for pregnant women. Not everyone in this situation will receive doxycycline — the deer tick bite needs to have occurred in a highly endemic area (Northeast, mid-Atlantic, upper Midwest, or West Coast). If you have localized (stage 1) Lyme disease with the telltale bull’s-eye rash, also known as erythema migrans, but no other significant symptoms, your doctor will most likely treat you with oral doxycycline, amoxicillin, or cefuroxime for 10 to 14 days. If you have early disseminated (stage 2) Lyme disease, which may include the characteristic rash along with cardiac or neurologic symptoms, the treatment duration is lengthened to 14 to 21 days. But if you have severe neurologic disease, such as meningitis, encephalitis, or nerve issues, or serious cardiac symptoms, your treatment will require taking intravenous ceftriaxone for 14 days. (2) Late disseminated (stage 3) Lyme disease is also treated with various antibiotics:
For Lyme disease that causes arthritis, 28 days of oral doxycycline, amoxicillin, or cefuroxime is prescribed. Additional courses of antibiotics may be necessary, depending on the severity and persistence of your symptoms.For Lyme disease affecting the nervous system (late neurologic Lyme disease), two to four weeks of intravenous ceftriaxone, cefotaxime, or penicillin is prescribed. (3)
Common side effects associated with most antibiotics include gastrointestinal problems, such as nausea, vomiting, and diarrhea. Allergic reactions can also occur, especially with medications derived from penicillin or sulfa. These reactions can range from a mild rash to anaphylactic shock. Some drugs can interact with antibiotics, so patients should tell their doctors about any medications they are taking. This condition is called post-treatment Lyme disease syndrome (PTLDS). It’s also sometimes referred to as chronic Lyme disease. It isn’t known what exactly causes PTLDS, but scientists think it may be a kind of immune response in which lingering remnants of the bacteria activate the immune system, leading the immune system to attack healthy cells. The condition may also be the result of residual damage to body tissues from Lyme disease, according to the Centers for Disease Control and Prevention (CDC). (4) There’s no approved treatment for PTLDS other than relieving specific symptoms, but people with the condition typically get better over time. Research has found no evidence that extended antibiotic treatment is beneficial for Lyme disease patients in whom symptoms persist after the recommended antibiotic treatment for acute Lyme disease. Long-term antibiotic or alternative treatments for Lyme disease have also been associated with serious complications. The CDC recommends that patients who are considering long-term antibiotic treatment for ongoing symptoms associated with a Lyme disease infection should discuss the associated risks with a healthcare provider. Bismacine, also known as chromacine, is an alternative-medicine drug that some people use to treat their Lyme disease. The Food and Drug Administration (FDA) warns that people should not use this injectable product, which has reportedly caused hospitalization and at least one death. (6) In addition, the FDA notes that bismacine contains high levels of bismuth, which can cause heart and kidney failure. Other alternative treatments include oxygen therapy, light therapy, and a variety of nutritional or herbal supplements. But there is no evidence that these treatments are clinically effective in the treatment of Lyme disease. (5) According to a 2011 analysis, there were likely a number of factors leading to the decision to suspend the vaccine. (7) These factors included:
Class-action lawsuitsCost of the vaccineLow public support due to efforts by anti-vaccine groupsConcerns that the vaccine could cause arthritisA difficult vaccination schedule.
The CDC also notes that the vaccine loses effectiveness over time, meaning that you’re probably no longer protected against Lyme disease today if you received the vaccine when it was available. In July 2017, the FDA granted Fast Track designation for another Lyme disease vaccine candidate, VLA15. (8) The FDA designation is intended to facilitate development and expedite review of drugs that treat serious conditions in order to get them to patients faster. Additional reporting by George Vernadakis.
