From the Guidelines
If Borrelia is detected, treatment with antibiotics should begin immediately, with doxycycline 100mg twice daily for 10-21 days being the standard first-line treatment for most adults, as recommended by the Infectious Diseases Society of America 1. The choice of antibiotic and duration of treatment depend on the stage of infection, severity of symptoms, and individual patient factors, such as age, pregnancy, and allergies.
- For adults, doxycycline is the preferred treatment, but alternative options include amoxicillin 500mg three times daily for 14-21 days or cefuroxime axetil 500mg twice daily for 14-21 days, particularly for children under 8, pregnant women, or those with doxycycline allergies 1.
- It's essential to complete the full course of antibiotics, even if symptoms improve, to ensure complete eradication of the bacteria and reduce the risk of developing more serious complications like arthritis, neurological problems, or cardiac issues.
- During treatment, some patients may experience a Jarisch-Herxheimer reaction, a temporary worsening of symptoms as bacteria die off, which should be monitored closely by a healthcare provider 1.
- Follow-up with a healthcare provider is crucial to monitor response to treatment, and if symptoms persist after treatment, additional evaluation may be needed as some patients develop Post-Treatment Lyme Disease Syndrome 1. The specific treatment guidelines are outlined in Table 3 of the Infectious Diseases Society of America's clinical practice guidelines, which provides recommendations for various manifestations of Lyme disease, including erythema migrans, early neurologic disease, and late disease 1.
From the FDA Drug Label
Relapsing fever due to Borrelia recurrentis. The treatment for Borrelia detected is doxycycline.
- The drug of choice is doxycycline for the treatment of infections caused by Borrelia recurrentis 2.
- Doxycycline is indicated for the treatment of relapsing fever due to Borrelia recurrentis.
From the Research
Borrelia Detection and Treatment
If Borrelia is detected, the next steps typically involve treatment with antibiotics. The choice of antibiotic and treatment duration may vary depending on the stage and severity of the infection.
Treatment Options
- Doxycycline is a commonly recommended antibiotic for the treatment of Borrelia infections, including Lyme disease 3, 4, 5, 6.
- Ceftriaxone is another antibiotic that may be used, particularly for more severe cases or for patients with certain medical conditions 3, 5, 6.
- Azithromycin may also be considered, especially for patients with early-stage infections or those who cannot tolerate doxycycline or ceftriaxone 4, 7.
Treatment Duration and Efficacy
- The duration of treatment typically ranges from 2 to 4 weeks, depending on the antibiotic and the stage of the infection 3, 4, 5, 6.
- Studies have shown that doxycycline and ceftriaxone are equally effective in treating Borrelia infections, with high cure rates and minimal side effects 3, 5, 6.
- Azithromycin has also been shown to be effective, particularly in the early stages of infection 4, 7.
Considerations and Side Effects
- Patients with Borrelia infections should be monitored for potential side effects, such as gastrointestinal symptoms, photosensitivity, and allergic reactions 3, 4, 5, 6.
- The choice of antibiotic and treatment duration should be individualized based on the patient's medical history, symptoms, and response to treatment 3, 4, 5, 7, 6.