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Clinical Microbiology Reviews, July 2009, p. 387-395, Vol. 22, No. 3
0893-8512/09/$08.00+0     doi:10.1128/CMR.00004-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Antibiotic Treatment of Animals Infected with Borrelia burgdorferi

Gary P. Wormser1* and Ira Schwartz2 Author Bios

Division of Infectious Diseases, Departments of Medicine,1 Microbiology and Immunology, New York Medical College, Valhalla, New York 105952

Summary: Despite resolution of the objective manifestations of Lyme disease after antibiotic treatment, a minority of patients have fatigue, musculoskeletal pain, and/or difficulties with concentration or short-term memory of uncertain etiology; these are called post-Lyme disease symptoms or, in more severe cases, post-Lyme disease syndrome or "chronic Lyme disease." Several recent studies in which Borrelia burgdorferi-infected animals were treated with antibiotic therapy have demonstrated the presence of PCR positivity for B. burgdorferi DNA in the absence of culture positivity. In mice that were treated with antibiotic therapy, residual spirochetes could be taken up by ticks during a blood meal and could be transmitted to SCID mice. These spirochetes are attenuated; their presence is not associated with either inflammation or disease. In this review the methodology and findings of these studies are critically analyzed, and the significance of the results with regard to human Lyme disease is evaluated, with special emphasis on whether these studies provide useful insights into post-Lyme disease syndrome. A serious methodological concern is the failure to consider the pharmacokinetic-pharmacodynamic properties of the antibiotic in choosing the dosage regimen used. We conclude that there is no scientific evidence to support the hypothesis that such spirochetes, should they exist in humans, are the cause of post-Lyme disease syndrome.

* Corresponding author. Mailing address: New York Medical College, Division of Infectious Diseases, Munger Pavilion Room 245, Valhalla, NY 10595. Phone: (914) 594-4507. Fax: (914) 594-4673. E-mail: gary_wormser{at}nymc.edu

Clinical Microbiology Reviews, July 2009, p. 387-395, Vol. 22, No. 3
0893-8512/09/$08.00+0     doi:10.1128/CMR.00004-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Barthold, S. W., Hodzic, E., Imai, D. M., Feng, S., Yang, X., Luft, B. J. (2010). Ineffectiveness of Tigecycline against Persistent Borrelia burgdorferi. Antimicrob. Agents Chemother. 54: 643-651 [Abstract] [Full Text]  


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