Chronic Lyme disease: misconceptions and challenges for patient management

Figures & data

Table 1 Western blot interpretation criteria

IgM (two required)	IgG (five required)
24 (OspC)	18
39	21
41 (Fla)	28
	30
	39
	41
	45
	58
	66
	93
For use in acute disease only	For patients with established disease

Table 2 Commonly used antimicrobial regimens

Disorder	Regimen
Non-neurologic disease	Amoxicillin 500 mg po tid or doxycycline 100 mg po bid or cefuroxime axetil 500 mg po bid, all for 14–28 days
Acute neuroborreliosis (meningitis, radiculitis, cranial neuritis)	Ceftriaxone 2 g/day for 14–21 days orcefotaxime 2 g tid for 14–21 days, or penicillin 24 MU/day ×14–21 days or probably po doxycycline 200–400 mg/day for 21–42 days
Encephalomyelitis	Ceftriaxone 2 g/day for 14–28 days or cefotaxime 2 g tid for 14–28 days, or penicillin 24 MU/day ×14–28 days
Chronic or recurrent neuroborreliosis(eg, treatment failure after first course)	Ceftriaxone 2 g/day for 28 days or cefotaxime 2 g tid for 28 days
Disease resistant to oral treatment	Ceftriaxone 2 g/day for 14–28 days or cefotaxime 2 g tid for 14–28 days, or penicillin 24 MU/day ×14–28 days

Note: Tetracyclines such as doxycycline should not be used in pregnant women or in children aged 8 years or under.

Abbreviations: po, oral; tid, thrice daily; bid, twice daily.