From the Research
Lyme disease symptoms typically appear in stages, beginning with a characteristic bull's-eye rash called erythema migrans at the site of the tick bite in about 70-80% of infected people, and prompt recognition of symptoms is crucial as early antibiotic treatment, such as piperacillin, can result in full recovery and prevent progression to later stages of the disease. The symptoms of Lyme disease can be divided into several stages, including early localized infection, early disseminated infection, and late disseminated infection 1. Early symptoms resemble flu-like illness, including fever, chills, fatigue, body aches, headache, neck stiffness, and swollen lymph nodes. If left untreated, the infection can spread to joints, causing severe arthritis with joint pain and swelling, particularly in the knees. Neurological problems may develop weeks or months later, including meningitis, temporary facial paralysis (Bell's palsy), numbness or weakness in limbs, and impaired muscle movement. Some patients experience heart problems like irregular heartbeat. Late-stage Lyme disease can cause arthritis that persists in joints, particularly knees, and neurological symptoms like encephalopathy affecting memory, concentration, and sleep.
The most recent and highest quality study, published in 2025, found that piperacillin, a beta-lactam antibiotic, can specifically treat Lyme disease in mice at a 100-fold lower dose than the effective dose of doxycycline without affecting the murine microbiome 2. This study suggests that piperacillin may offer clinicians another therapeutic option for Lyme disease. Other studies have also investigated the efficacy and safety of antibiotics for treating Lyme disease, including a network meta-analysis published in 2021, which found that oral amoxicillin, oral azithromycin, injectable ceftriaxone, and injectable cefotaxime were effective for treating Lyme disease 3.
Key points to consider when diagnosing and treating Lyme disease include:
- The disease is transmitted to humans through the bite of the Ixodes tick (Ixodes scapularis and Ixodes pacificus) 1
- The tick must feed for at least 36 hours for transmission of the causative bacterium, Borrelia burgdorferi, to occur 1
- Early symptoms can resemble flu-like illness, and prompt recognition of symptoms is crucial for effective treatment 1
- Antibiotic treatment, such as piperacillin, can result in full recovery and prevent progression to later stages of the disease 2
- The efficacy and safety of antibiotics for treating Lyme disease can vary, and the most recent and highest quality studies should be consulted to inform treatment decisions 3, 2