Table 1 Diversity of chronic Lyme disease studies: populations, treatments, durations and outcomes.
From: Generalizability in two clinical trials of Lyme disease
Study | Year | Size | Patient population | Type of study | Treatment | Duration of Rx (days) | Outcome |
|---|---|---|---|---|---|---|---|
Dattwyler [20] | 1988 | 23 | Late Lyme disease in the NorthEast (NE) USA | Randomized trial | IV Ceftriaxone vs IV penicillin | 14 vs 10 | 92% responded to ceftriaxone, 50% improved with penicillin |
Logigian [15] | 1990 | 27 | Neurologic LD patients in NE USA | Case series | IV Ceftriaxone | 14 | 63% improved, 22% improved but then relapsed, and 15% had no change in their condition |
Hassler [19] | 1990 | 135 | Stage three borreliosis manifestations of at least six months' duration in Germany | Randomized trial | IV Cefotaxime vs IV penicillin G | 10 | 87.9% vs 61.3% respectively Full or incomplete remission of symptoms in. |
Wahlberg [17] | 1994 | 100 | Consecutive LD patients in Finland | Case series | IV Ceftriaxone, oral amoxicillin plus probenecid and/or oral cefhadroxil.* | 14 to114 | 31% of 13 treatments successful with 14 days of IV ceftriaxone alone, 89% of 56 treatments with IV ceftriaxone followed by 100 days of amoxycillin plus probenecid successful, and 83% of 23 treatments with ceftriaxone followed by 100 days of cephadroxil successful. |
Donta [18] | 1997 | 277 | Chronic LD in NE USA | Case series | Oral tetracycline | 30 to 330 | 20% of the patients were cured; 70% of the patients' conditions improved. |
Logigian [16] | 1999 | 18 | Neurologic LD in NE USA | Case series | IV ceftriaxone | 28 | 100% of 18 patients rated themselves as back to normal or improved. |
Klempner [14] | 2001 | 107 | LD with persistent symptoms in NE USA | Randomized trial | IV ceftriaxone + oral doxycycline | 90 | 40% vs 36% for treatment vs placebo in improvement in quality of life (SF-36) |
Krupp [46] | 2003 | 55 | LD with disabling fatigue in NE USA | Randomized trial | IV ceftriaxone | 30 | 69% rx vs 23% for treatment vs placebo in the primary outcome – fatigue. No improvement on cognitive function or the clearance of Borrelia OspA antigen in the spinal fluid |
Donta [25] | 2003 | 235 | LD with fatigue, musculoskeletal pain, and neurocognitive dysfunction in NE USA | Case series | Oral macrolide + hydroxychloroquine | 90 | 80% had self reported improvements of 50% or more |
Dattwyler [27] | 2005 | 201 | Late LD in NE USA | Randomized trial | IV ceftriaxone | 14 vs. 28 | 76% vs 70% clinical cure rates for 14 and 28 days respectively |
Borg [26] | 2005 | 65 | Neurologic LD in Sweden | Randomized trial | IV ceftriaxone vs oral doxycycline | 10 to 14 | 79% vs 72% completely recovered, the remaining improved. |