The Minocycline in the LYME DISEASE, a Terminator Antibiotic ?.
La Minociclina en La ENFERMEDAD DE LYME, un Antibiotico Exterminador ?
EDITORIAL ENGLISH
===================
Hello friends of the DERMAGIC EXPRESS network today bring you a very
interesting topic THE MINOCYCLE IN LYME DISEASE. First of all I will
tell you once again that this is not the first time I speak of this
"OLD ANTIBIOTIC" family of tetracyclines which many years ago, I repeat
many years ago was discovered the ABILITY or CAPACITY
to finish or destroy many MICROORGANISMS or bacteria which scientists considered
practically "INVINCIBLE" or "IMPOSSIBLE" to exterminate.
The first and perhaps most important that I will show you is THE HANSEN'S BACILLI, the MYCOBACTERIUM LEPRAE, a millenary and apocalyptic bacterium, responsible for LEPROSY mentioned in the BIBLE in the LEVITIC'S chapter , described and discovered by the scientist ARMAUER HANSEN in The year of 1.873.
This MYCOBACTERIUM was considered "INVINCIBLE" until SULPHONES appeared, (DDS) diaminodiphenylsulfone, RAFAMPICINE, and CLOFAZIMINE. I am speaking of the years 1940-1945 when these medicines appeared, which together with IMMUNOTHERAPY, decreed the closure of LEPROSERIES throughout the world wide. All this I told you in THE LEPROSY CHAPTERS.
And a few years later came the MINOCYCLINE (MINO), an antibiotic that is changing the history of the evolution of some diseases today. This antibiotic is a family of "old" TETRACYCLINES whose first antibiotic was synthesized in the year 1.940 under the name CHLORTETRACYCLINE (AUREOMYCIN) by the scientist Benjamin Minge Duggar, of LABORATORY LEDERLE.
Subsequent to this discovery, other TETRACYCLINES appeared on the market: OXYTETRACYCLINE, DEMECLOCYCLINE, LYMECYCLINE, MECLOCYCLINE. METHACYCLINE, ROLITETRACYCLINE TIGECYCLINE AND OUR "FAMOUS" MINOCYCLINE.
Specifically MINOCYCLINE (MINO) was born in 1.961 and placed on the market in the year 1.967, under the name MINOCIN, which still exists today. It's been 50 years, half a century since its discovery. Its main use was to combat ACNE bacteria, but other properties were later described.
In March 1.999, 17, I launched the article THE MINOCYCLINE, THE GOOD, THE BAD AND THE UGLY, which was published in the Dermatology's magazine of Chile, and updated on February 10, 2,017 under the name MINOCYCLINE ALZHEIMER AND OTHER NEUROLOGICAL DISORDERS, for its new uses. This means that I have 20 years talking about the benefits of this antibiotic that differentiate it from the rest of its congeneries.
In the 1980s and 1990s, MINOCYCLINE was shown to have a highly potent effect against MYCOBACTERIUM LEPRAE and several therapeutic regimens were designed in conjunction with other antibiotics such as OFLOXACINE, CLARITROMYCIN, AND AMOXYCYLIN to combat LEPROSY, references 3,4,5,6,7,8.
Recently it has been discovered its effect NEUROPROTECTOR, being used today in diseases like ALZHEIMER, PARKINSON, SCHIZOPHRENIA, BIPOLAR DISORDERS, AUTOIMMUNE ENCEPHALOMYELITIS AND MULTIPLE SCLEROSIS.
Then you'll be asking yourself "WHAT HAS" this antibiotic that THAT MAKES IT DIFFERENT FROM ITS CONGENERIES, and I'll tell you: CLEAR and SCIENTIFICALLY
1.) HAS MORE BROAD SPECTRUM THAN OTHER TETRACYCLINES.
2.) HAVE AN AVERAGE LIFETIME IN SERUM: 2 TO 4 TIMES GREATER THAN OTHER TETRACYCLINES.
3.) IT HAS GREATER LIPOSOLUBILITY THAN OTHER TETRACYCLINES WHICH ALLOWS IT TO HAVE GREATER PENETRATION IN THE TISSUES AS PROSTATE, BRAIN AND CENTRAL NERVOUS SYSTEM.
Are you understanding me? you are copying me? Are you feeling me ?
That is why today we have found this antibiotic with uses that the human never thought could be useful.
NOW I AM GOING TO EXPLAIN THE RELATIONSHIP OF LYME DISEASE WITH MINOCYCLINE.
If you go to review the most known DATABASES you will find that the antibiotics most used in LYME DISEASE of the group of tetracyclines are OXYTETRACYCLINE, and LATELY TIGECYCLINE, without ruling out the MINOCYCLINE.
And the most used, family of PENICILLINS, DOXYCYCLINE, Also an old antibiotic that was born in 1.961 and came on the market in 1.967 by the laboratory PFIZER
A few days ago I read an article of a patient with LYME DISEASE who developed BELL'S Paralysis and its treatment with DOXYCYCLINE failure, they prescribed MINOCYCLINE and the patient was healthy. In many articles it appears as a first option against LYME DISEASE DOXYCYLINE, and others, but not the MINOCYCLINE, much less the G PENICILLIN, of which I did not find almost studies.
But if you get to "DIG" well the databases you find the "SURPRISE" that MINOCYCLINE in the 80s and 90s, was discovered its effectiveness in LYME DISEASE, in fact there are also some (few) Studies where it is shown that PENICILLIN G PROCAINIC is also effective in this disease, and here comes the big question
Why ? these two antibiotics G PENICILLIN AND MINOCYCLINE (MINO) are not used as the FIRST ELECTION against LYME disease? Or in combination with others? I know that some scientists DO USE THE MINOCYCLINE, but very few or almost none of the G PENICILLIN, knowing that the BORRELIA is a SPIROQUETTE like the TREPONEMA PALLIDUM that causes SYPHIILIS and that it "DIES" with PENICILLIN.
This review I am doing to REMEMBER TO SOME SCIENTISTS that MINOCYCLINE was one of the first antibiotics that after THE DAPSONE, RIFAMPICIN and CLOFAZYMINE, has the ability, to eliminate a MICRO-ORGANISM as "HARD DIE" as the MYCOBACTERIUM LEPRAE, this speaks for itself of its "POWER" no matter how "OLD" it is.
What do I want to tell you with this? That I have knowledge of the "TREMENDOUS" health problem worldwide that is causing the BORRELIA BURGORFERI and you have at your disposal 2 ANTIBIOTICS such as G PENICILLIN and MINOCYCLINE that can help you with all those patients, especially those suffering from NEUROBORRELIOSIS, because of the great capacity it has this antibiotic (MINOCYCICLINE) to penetrate the brain tissues.
You also have OFLOXACIN AND CLARITHROMYCIN, so I suggest researchers use them in LYME DISEASE.
Of course against this LYME DISEASE has been used numerous antibiotics such as: ciprofloxacin, amoxicillin, erythromycin, tetracycline, cephalosporins and others.
Finally, as I said in one of my reviews on LYME DISEASE ...
"...DO NOT STOP CLAIMING YOUR RIGHTS ON HEALTH, TREATMENT AND INSURANCE POLICY, BUT ALSO DO NOT HESITATE TO MAKE A GOOD TREATMENT ... DO NOT GIVE UP ..."
And also the old axiom is fulfilled:
"...THE SCIENTIFIC ARTICLES DO NOT PRESCRIBE FOR MORE" OLD "THAT IS THE DATE OF PUBLICATION ..."
And we can also summarize that two old antibiotics like DOXYCYCLINE, a family of penilins and MINOCYCLINE, a family of tetracyclines invented 50 years ago, are the ones who are giving the big battle against LYME DISEASE today. I particularly think MINOCYCLINE is more powerful
Greetings to all
Dr. José Lapenta.
The first and perhaps most important that I will show you is THE HANSEN'S BACILLI, the MYCOBACTERIUM LEPRAE, a millenary and apocalyptic bacterium, responsible for LEPROSY mentioned in the BIBLE in the LEVITIC'S chapter , described and discovered by the scientist ARMAUER HANSEN in The year of 1.873.
This MYCOBACTERIUM was considered "INVINCIBLE" until SULPHONES appeared, (DDS) diaminodiphenylsulfone, RAFAMPICINE, and CLOFAZIMINE. I am speaking of the years 1940-1945 when these medicines appeared, which together with IMMUNOTHERAPY, decreed the closure of LEPROSERIES throughout the world wide. All this I told you in THE LEPROSY CHAPTERS.
And a few years later came the MINOCYCLINE (MINO), an antibiotic that is changing the history of the evolution of some diseases today. This antibiotic is a family of "old" TETRACYCLINES whose first antibiotic was synthesized in the year 1.940 under the name CHLORTETRACYCLINE (AUREOMYCIN) by the scientist Benjamin Minge Duggar, of LABORATORY LEDERLE.
Subsequent to this discovery, other TETRACYCLINES appeared on the market: OXYTETRACYCLINE, DEMECLOCYCLINE, LYMECYCLINE, MECLOCYCLINE. METHACYCLINE, ROLITETRACYCLINE TIGECYCLINE AND OUR "FAMOUS" MINOCYCLINE.
Specifically MINOCYCLINE (MINO) was born in 1.961 and placed on the market in the year 1.967, under the name MINOCIN, which still exists today. It's been 50 years, half a century since its discovery. Its main use was to combat ACNE bacteria, but other properties were later described.
In March 1.999, 17, I launched the article THE MINOCYCLINE, THE GOOD, THE BAD AND THE UGLY, which was published in the Dermatology's magazine of Chile, and updated on February 10, 2,017 under the name MINOCYCLINE ALZHEIMER AND OTHER NEUROLOGICAL DISORDERS, for its new uses. This means that I have 20 years talking about the benefits of this antibiotic that differentiate it from the rest of its congeneries.
In the 1980s and 1990s, MINOCYCLINE was shown to have a highly potent effect against MYCOBACTERIUM LEPRAE and several therapeutic regimens were designed in conjunction with other antibiotics such as OFLOXACINE, CLARITROMYCIN, AND AMOXYCYLIN to combat LEPROSY, references 3,4,5,6,7,8.
Recently it has been discovered its effect NEUROPROTECTOR, being used today in diseases like ALZHEIMER, PARKINSON, SCHIZOPHRENIA, BIPOLAR DISORDERS, AUTOIMMUNE ENCEPHALOMYELITIS AND MULTIPLE SCLEROSIS.
Then you'll be asking yourself "WHAT HAS" this antibiotic that THAT MAKES IT DIFFERENT FROM ITS CONGENERIES, and I'll tell you: CLEAR and SCIENTIFICALLY
1.) HAS MORE BROAD SPECTRUM THAN OTHER TETRACYCLINES.
2.) HAVE AN AVERAGE LIFETIME IN SERUM: 2 TO 4 TIMES GREATER THAN OTHER TETRACYCLINES.
3.) IT HAS GREATER LIPOSOLUBILITY THAN OTHER TETRACYCLINES WHICH ALLOWS IT TO HAVE GREATER PENETRATION IN THE TISSUES AS PROSTATE, BRAIN AND CENTRAL NERVOUS SYSTEM.
Are you understanding me? you are copying me? Are you feeling me ?
That is why today we have found this antibiotic with uses that the human never thought could be useful.
NOW I AM GOING TO EXPLAIN THE RELATIONSHIP OF LYME DISEASE WITH MINOCYCLINE.
If you go to review the most known DATABASES you will find that the antibiotics most used in LYME DISEASE of the group of tetracyclines are OXYTETRACYCLINE, and LATELY TIGECYCLINE, without ruling out the MINOCYCLINE.
And the most used, family of PENICILLINS, DOXYCYCLINE, Also an old antibiotic that was born in 1.961 and came on the market in 1.967 by the laboratory PFIZER
A few days ago I read an article of a patient with LYME DISEASE who developed BELL'S Paralysis and its treatment with DOXYCYCLINE failure, they prescribed MINOCYCLINE and the patient was healthy. In many articles it appears as a first option against LYME DISEASE DOXYCYLINE, and others, but not the MINOCYCLINE, much less the G PENICILLIN, of which I did not find almost studies.
But if you get to "DIG" well the databases you find the "SURPRISE" that MINOCYCLINE in the 80s and 90s, was discovered its effectiveness in LYME DISEASE, in fact there are also some (few) Studies where it is shown that PENICILLIN G PROCAINIC is also effective in this disease, and here comes the big question
Why ? these two antibiotics G PENICILLIN AND MINOCYCLINE (MINO) are not used as the FIRST ELECTION against LYME disease? Or in combination with others? I know that some scientists DO USE THE MINOCYCLINE, but very few or almost none of the G PENICILLIN, knowing that the BORRELIA is a SPIROQUETTE like the TREPONEMA PALLIDUM that causes SYPHIILIS and that it "DIES" with PENICILLIN.
This review I am doing to REMEMBER TO SOME SCIENTISTS that MINOCYCLINE was one of the first antibiotics that after THE DAPSONE, RIFAMPICIN and CLOFAZYMINE, has the ability, to eliminate a MICRO-ORGANISM as "HARD DIE" as the MYCOBACTERIUM LEPRAE, this speaks for itself of its "POWER" no matter how "OLD" it is.
What do I want to tell you with this? That I have knowledge of the "TREMENDOUS" health problem worldwide that is causing the BORRELIA BURGORFERI and you have at your disposal 2 ANTIBIOTICS such as G PENICILLIN and MINOCYCLINE that can help you with all those patients, especially those suffering from NEUROBORRELIOSIS, because of the great capacity it has this antibiotic (MINOCYCICLINE) to penetrate the brain tissues.
You also have OFLOXACIN AND CLARITHROMYCIN, so I suggest researchers use them in LYME DISEASE.
Of course against this LYME DISEASE has been used numerous antibiotics such as: ciprofloxacin, amoxicillin, erythromycin, tetracycline, cephalosporins and others.
Finally, as I said in one of my reviews on LYME DISEASE ...
"...DO NOT STOP CLAIMING YOUR RIGHTS ON HEALTH, TREATMENT AND INSURANCE POLICY, BUT ALSO DO NOT HESITATE TO MAKE A GOOD TREATMENT ... DO NOT GIVE UP ..."
And also the old axiom is fulfilled:
"...THE SCIENTIFIC ARTICLES DO NOT PRESCRIBE FOR MORE" OLD "THAT IS THE DATE OF PUBLICATION ..."
And we can also summarize that two old antibiotics like DOXYCYCLINE, a family of penilins and MINOCYCLINE, a family of tetracyclines invented 50 years ago, are the ones who are giving the big battle against LYME DISEASE today. I particularly think MINOCYCLINE is more powerful
Greetings to all
Dr. José Lapenta.
EDITORIAL SPANISH
===================
Hola amigos de la red DERMAGIC EXPRESS te trae hoy un tema bastante
interesante LA MINOCICLINA EN LA ENFERMEDAD DE LYME. Primeramente te
voy a decir una vez más, que no es la primera vez que hablo de este "VIEJO
ANTIBIOTICO", familia de las tetraciclinas el cual hace muchos años, repito
hace muchos años se le descubrió la HABILIDAD o CAPACIDAD de acabar o destruir
unos cuantos MICROORGANISMOS o bacterias las cuales los científicos
consideraban prácticamente "INVENCIBLES" o "IMPOSIBLES" de exterminar.
El primero y quizá mas importante que te voy a mostrar es EL BACILO DE HANSEN, el MYCOBACTERIUM LEPRAE, bacteria milenaria y apocalíptica, causante de la LEPRA, descrita en la BIBLIA en el capitulo LEVITICO, descrito y descubierto por el científico Alemán ARMAUER HANSEN en él año de 1.873.
Esta MYCOBACTERIA se le considero " INVENCIBLE" hasta que aparecieron las SULFONAS, (DDS) diaminodifenilsulfona, LA RAFAMPICINA, Y el CLOFAZIMINE. Te estoy hablando de los años 1.940-1.945 cuando aparecieron estas medicinas, que conjuntamente con la INMUNOTERAPIA, decretaron el cierre de las LEPROSERIAS en todo el mundo. Todo esto te lo conté en LOS CAPITULOS SOBRE LA LEPRA.
El primero y quizá mas importante que te voy a mostrar es EL BACILO DE HANSEN, el MYCOBACTERIUM LEPRAE, bacteria milenaria y apocalíptica, causante de la LEPRA, descrita en la BIBLIA en el capitulo LEVITICO, descrito y descubierto por el científico Alemán ARMAUER HANSEN en él año de 1.873.
Esta MYCOBACTERIA se le considero " INVENCIBLE" hasta que aparecieron las SULFONAS, (DDS) diaminodifenilsulfona, LA RAFAMPICINA, Y el CLOFAZIMINE. Te estoy hablando de los años 1.940-1.945 cuando aparecieron estas medicinas, que conjuntamente con la INMUNOTERAPIA, decretaron el cierre de las LEPROSERIAS en todo el mundo. Todo esto te lo conté en LOS CAPITULOS SOBRE LA LEPRA.
Y algunos años después llego la MINOCICLINA (MINO), un antibiótico que está cambiando la historia de la evolución de algunas enfermedades hoy día. Este antibiótico es familia de las "viejas" TETRACICLINAS cuyo primer antibiótico fue sintetizado en él año de 1.940 bajo el nombre de CLORTETRACICLINA (AUREOMICINA) por el científico Benjamín Minge Duggar, del LABORATORIO LEDERLE.
Posterior a este descubrimiento fueron apareciendo en el mercado otras TETRACICLINAS: OXITETRACICLINA, DEMECLOCICLINA, LYMECICLINA, MECLOCICLINA. METHACICLINA, ROLITETRACICLINA, TIGECICLINA Y nuestra "FAMOSA" MINOCICLINA.
Especificamente la MINOCICLINA (MINO) nació en él año 1.961 y colocada en el mercado en el año de 1.967, bajo el nombre DE MINOCIN, el cual existe todavía hoy día. Han pasado 50 años, medio siglo desde su descubrimiento. Su uso principal fue destinado a combatir la bacteria del ACNE, pero posteriormente se le describieron otras propiedades.
En el año de 1.999 17, de Marzo, yo lance a la red el articulo LA MINOCICLINA, LO BUENO, LO MALO Y LO FEO, el cual fue publicado en la REVISTA DE DERMATOLOGIA DE EL PAIS CHILE, y lo relance actualizado el 10 de febrero de 2.017 bajo el nombre de MINOCICLINA ALZHEIMER Y OTROS TRASTORNOS NEUROLOGICOS, por sus nuevos usos. Es decir tengo casi 20 años hablándoles de las bondades de este antibiótico que lo diferencian del resto de sus congéneres.
En los años 80 y 90 se demostró que la MINOCICLINA tiene un efecto altamente potente contra el MYCOBACTERIUM LEPRAE y se diseñaron varios esquemas terapéuticos en conjunto con otros antibióticos como la OFLOXACINA, CLARITROMICINA Y AMOXICILINA, para combatir la LEPRA, referencias 3,4,5,6,7,8.
Últimamente se le descubrió su efecto NEUROPROTECTOR, siendo utilizado hoy día en enfermedades como el ALZHEIMER, PARKINSON, ESQUIZOFRENIA, TRASTORNOS BIPOLARES ENCEFALOMIELITIS AUTOINMUNE Y ESCLEROSIS MULTIPLE.
Entonces te estarás preguntando que "TIENE" este antibiótico que lo diferencia de sus congéneres, y te lo voy a decir: CLARO y CIENTIFICAMENTE
1.) TIENE UN MAYOR AMPLIO ESPECTRO QUE OTRAS TETRACICLINAS.
2.) TIENE UN TIEMPO DE VIDA MEDIA EN EL SUERO: 2 A 4 VECES MAYOR QUE OTRAS TETRACICLINAS.
3.) TIENE MAYOR LIPOSOLUBILIDAD QUE LAS DEMAS TETRACICLINAS LO CUAL LE PERMITE TENER UNA MAYOR PENETRACION EN LOS TEJIDOS COMO PROSTATA, CEREBRO Y SISTEMA NERVIOSO CENTRAL.
Me estas entendiendo? me estas copiando? Me estas sintiendo ?
Es por ello que hoy día se le ha encontrado a este antibiótico con MEDIO SIGLO EN EL MERCADO usos que el humano jamás pensó que podría ser útil.
AHORA VOY A EXPLICARTE LA RELACION DE LA ENFERMEDAD DE LYME CON LA MINOCICLINA.
Si te pones a revisar las más conocidas BASES DE DATOS te encontraras que los antibióticos más utilizados en la ENFERMEDAD DE LYME del grupo de las tetraciclinas son la OXITETRACICLINA, y ULTIMAMENTE la TIGECICLINA, sin descartar por supuesto la MINOCICLINA.
Y el más utilizado, de la familia de las PENICILINAS, LA DOXICICLINA, También un antibiótico antiguo que nació en 1.961 y salió al mercado en 1.967 por el laboratorio PFIZER
Hace unos días leí un artículo de un paciente con ENFERMEDAD DE LYME que desarrollo parálisis de BELL y su tratamiento con DOXICICLINA fracaso, le recetaron MINOCICLINA y el paciente se sano. En muchos artículos aparece como primera opción contra la ENFERMEDAD DE LYME la DOXICILINA, y otros, pero no la MINOCILINA y mucho menos la PENICLINA G, de la cual no encontré casi estudios.
Pero si te pones a "ESCARBAR" bien las bases de datos te encuentras con la "SORPRESA" de que la MINOCICLINA en los años 80s y 90s, se le descubrió su efectividad en la ENFERMEDAD DE LYME, de hecho también hay algunos (pocos) estudios donde se demuestra que la PENICILINA G PROCAINICA también es efectiva en esta enfermedad, y aquí viene la gran pregunta ?
Porque estos dos antibióticos PENICILINA G Y MINOCICLINA (MINO) no son utilizados como PRIMERA ELECCION CONTRA enfermedad de LYME? O en combinación con otros? Yo se que algunos científicos SI UTILIZAN LA MINOCICLINA, pero muy pocos o casi ninguno la PENICILINA sabiendo que la BORRELIA ES UNA ESPIROQUETA como el TREPONEMA PALLIDUM que causa la SIFILIS y que "MUERE" con PENICILINA.
Esta revisión la estoy haciendo para RECORDARLES A ALGUNOS CIENTIFICOS que la MINOCICLINA fue uno de los primeros antibióticos que luego de LA DAPSONA, RIFAMPICINA Y CLOFAZIMINA, tiene la habilidad, capacidad de ELIMINAR UN MICRO-ORGANISMO tan "DURO DE MATAR" como el MYCOBACTERIUM LEPRAE, esto habla por sí solo de su "POTENCIA" no importa lo "VIEJO" que sea.
Que quiero decirte con esto ? que tengo conocimiento del TREMENDO problema de salud a nivel mundial que está ocasionando la BORRELIA BURGORFERI y tienes a tu disposición 2 ANTIBIOTICOS como PENICILINA G Y MINOCICLINA que pueden ayudarte con todos esos pacientes, sobre todo los que padecen de NEUROBORRELIOSIS, por la gran capacidad que tiene este antibiótico (MINOCICLINA) de penetrar los tejidos cerebrales.
También tienes OFLOXACINA Y CLARITROMICINA, entonces les sugiero a los investigadores UTILIZARLOS en la ENFERMEDAD DE LYME.
Por supuesto contra esta ENFERMEDAD DE LYME se ha utilizado numerosos antibióticos como: ciprofloxacino, amoxicilina, eritromicina, tetraciclina, cefalosporinas y otros
Para finalizar, como te dije en una de mis revisiones sobre la ENFERMEDAD DE LYME...
"NO DEJES DE RECLAMAR TUS DERECHOS SOBRE SALUD, TRATAMIENTOS Y POLIZAS DE SEGURO, PERO TAMBIEN NO DEJES DE HACER UN BUEN TRATAMIENTO... NO SE RINDAN..."
Y también se cumple el viejo axioma:
"...LOS ARTICULOS CIENTIFICOS NO PRESCRIBEN POR MAS "VIEJA" QUE SEA LA DATA DE PUBLICACION..."
Y tambien podemos resumir que dos viejos antibioticos como la DOXICICLINA, familia de las penilinas y la MINOCICLINA, familia de las tetraciclinas inventadas hace 5o años, son quienes estan dando la gran batalla contra LA ENFERMEDAD DE LYME hoy dia. Yo particularmente creo que la MINOCICLINA es mas potente
Saludos a todos
Dr. José Lapenta.
=======================================================================
REFERENCIAS BIBLIOGRAFICAS/ BIBLIOGRAPHICAL REFERENCES
=======================================================================
1.) Progression of Lyme disease to Bell's Palsy despite treatment with
doxycycline.
2.) Minocycline as A Substitute for Doxycycline in Targeted Scenarios: A
Systematic Review.
3.) Minocycline in lepromatous leprosy.
4.) Efficacy of minocycline in single dose and at 100 mg twice daily for
lepromatous leprosy.
5.) Field trial on efficacy of supervised monthly dose of 600 mg rifampin,
400 mg ofloxacin and 100 mg minocycline for the treatment of leprosy; first
results.
plus minocycline, with or without rifampin, against Mycobacterium leprae in
mice and in lepromatous patients.
single-lesion paucibacillary leprosy. Single-lesion Multicentre Trial Group.
minocycline, with or without ofloxacin, against Mycobacterium leprae in
patients.
9.) Chronic Lyme borreliosis at the root of multiple sclerosis--is a cure
with antibiotics attainable?
10.) In-vitro and in-vivo antibiotic susceptibilities of Lyme disease
Borrelia isolated in China.
11.) Erythema migrans: three weeks treatment for prevention of late Lyme
borreliosis.
12.) No detection of Borrelia burgdorferi-specific DNA in erythema migrans
lesions after minocycline treatment.
13.) Susceptibility of the Lyme disease spirochete to seven antimicrobial
agents.
14.) Antibiotic therapy in early erythema migrans disease and related
disorders.
==================================================================
==================================================================
1.) Progression of Lyme disease to Bell's Palsy despite treatment with
doxycycline.
==================================================================
Int J Infect Dis. 2017 Jul 10. pii: S1201-9712(17)30182-0. doi:
10.1016/j.ijid.2017.07.004. [Epub ahead of print]
Marcos LA1, Yan Z2.
Author information
1
Department of Medicine, Division of Infectious Diseases, Stony Brook
University, Stony Brook, USA. Electronic address:
Luis.marcos@stonybrookmedicine.edu.
2
Department of Radiology, Stony Brook University, Stony Brook, USA.
Electronic address: zengmin.yan@stonybrookmedicine.edu.
Abstract
A 54 year-old healthy woman presented to the emergency department with a
right sided facial paralysis. About 3 weeks ago, she woke up and noticed an
attached engorged tick in her right lower extremity. A week later, she
noticed a mild to moderate right jaw pain which progressed to a severe right
facial pain so she visited her doctor. On physical, II to XII cranial nerve
examination was unremarkable. Doppler ultrasound did not show any vascular
abnormalities in temporal artery. Her inflammatory markers were within
normal limits (C-reactive protein:0.3mg/dL; sedimentation rate:6mm/h).
Further brain imaging by MRI reveled no abnormalities. Lyme serology
(antibodies against purified VlsE-1 and PepC10 antigens) was negative (index
value 0.6;≤0.90 negative). Complete blood count and metabolic panel were
within normal limits. Only objective physical finding was a right
erythematous ear canal so the patient was prescribed a 7-day course of
amoxicillin/clavulonic acid. Two days later, the rash in right leg increase
in size. It was described as 4cm rash circular with erythematous edges,
clearing and central erythema consistent with erythema migrans (EM) (bull's
eye). She was prescribed doxycycline 100mg orally twice a day. Five days
later went to see a neurologist due to worsening right facial shooting pain.
Patient had minimal gastrointestinal side effects from the antibiotic and
continued taking it every 12hours without interruption. Physical exam
revealed face symmetric, numbness in right chin in nerve distribution. She
was diagnosed with possible Lyme cranial neuritis. Doxycycline was continued
and pregabalin was started. On day #10 of doxycycline, she woke up and
noticed that her right face was paralyzed and unable to close the right eye
so she went to the local emergency department. The EM was improved from 4 to
2cm residual rash. Because of her headaches, a lumbar puncture and brain MRI
were recommended. Cerebrospinal spinal fluid analysis revealed only 3 WBCs,
protein 30.2g/dL, glucose 62mg/L, Lyme serology pair CSF fluid O.D.=0.114
(borderline), serum Lyme serology pair O.D.=0.409 (reactive), serum IgM
western blot was positive (bands present: 23 and 41kDa), serum IgG western
blot was indeterminate (bands: 41,58 and 93kDa), CRP remained less than
0.1mg/dL. MRI of brain showed new increased enhancement involving right
facial nerve (Fig. 1). She was discharged on minocycline 100mg orally twice
a day for 21 days. Two days later, her right side headaches improved
significantly. The facial paralysis completely resolved after 1 week. At 3
months follow-up, she recovered completely without any complications.
====================================================================
2.) Minocycline as A Substitute for Doxycycline in Targeted Scenarios: A
Systematic Review.
====================================================================
Open Forum Infect Dis. 2015 Nov 25;2(4):ofv178. doi: 10.1093/ofid/ofv178.
eCollection 2015 Dec.
Carris NW1, Pardo J2, Montero J3, Shaeer KM4.
Author information
1
Department of Pharmacotherapeutics and Clinical Research , University of
South Florida College of Pharmacy ; Departments of Family Medicine.
2
Department of Pharmacy , North Florida/South Georgia Veterans Health System
, Gainesville.
3
Internal Medicine , University of South Florida, Morsani College of Medicine
, Tampa.
4
Department of Pharmacotherapeutics and Clinical Research , University of
South Florida College of Pharmacy ; Internal Medicine , University of South
Florida, Morsani College of Medicine , Tampa.
Abstract
Doxycycline, a commonly prescribed tetracycline, remains on intermittent
shortage. We systematically reviewed the literature to assess minocycline as
an alternative to doxycycline in select conditions, given doxycycline's
continued shortage. We identified 19 studies, 10 of which were published
before 2000. Thirteen of the studies were prospective, but only 1 of these
studies was randomized. Based on the available data, we found minocycline to
be a reasonable substitute for doxycycline in the following scenarios: skin
and soft-tissue infections and outpatient treatment of community-acquired
pneumonia in young, otherwise healthy patients or in patients with
macrolide-resistant Mycoplasma pneumoniae, as well as Lyme disease
prophylaxis and select rickettsial disease should doxycycline be
unavailable.
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3.) Minocycline in lepromatous leprosy.
=============================================
Author
Fajardo TT Jr; Villahermosa LG; dela Cruz EC; Abalos RM; Franzblau SG;
Walsh GP
Address
Clinical Research Branch, Leonard Wood Memorial Center, Cebu City, The
Philippines.
Source
Int J Lepr Other Mycobact Dis, 63(1):8-17 1995 Mar
Abstract
Twelve patients were treated with three dose levels of minocycline for 30
days, primarily to detect the dose-related effects on Mycobacterium leprae
viability, followed by another 5 months of daily minocycline for overall
efficacy and persistence of clinical and antibacterial effects.
Subsequently, the patients were given standard WHO/MDT chemotherapy for
multibacillary leprosy. Clinical improvement was recognizable during the
first month, occurring much earlier among those on minocycline 200 mg daily
than those who received minocycline 100 mg daily. A similar change also was
observed in one patient 11 days after three daily doses of 100 mg of
minocycline. At the end of 6 months, all patients were clinically improved
with a slight reduction in the average bacterial index (BI) and logarithmic
index of bacilli in biopsy (LIB). The effects of minocycline on viability by
mouse foot pad inoculation and palmitic acid oxidation assays were noted
beginning at 10 to 14 days of daily dosing and becoming more definite after
30 days of treatment. Both tests correlated fairly well. Doses of 200 mg
daily did not appear to be more efficient than minocycline 100 daily.
Phenolic glycolipid-I (PGL-I) antigen determinations done on some patients
during the first month remained positive and did not correlate with changes
in viability results. At the end of 6 months, after 5 months of 100 mg of
minocycline monotherapy, no viable organisms could be demonstrated by mouse
foot pad inoculation and palmitic acid oxidation assays; assays for PGL-I
antigen were all negative.(ABSTRACT TRUNCATED AT 250 WORDS)
===================================================
4.) Efficacy of minocycline in single dose and at 100 mg twice daily for
lepromatous leprosy.
===================================================
Int J Lepr Other Mycobact Dis (United States), Dec 1994, 62(4) p568-73
AUTHOR(S): Gelber RH; Murray LP; Siu P; Tsang M; Rea TH
AUTHOR'S ADDRESS: San Francisco Regional Hansen's Disease Program, CA 94115.
PUBLICATION TYPE: CLINICAL TRIAL; JOURNAL ARTICLE
ABSTRACT:
A clinical trial of minocycline in a total of 10 patients with previously
untreated lepromatous leprosy was conducted in order to evaluate the
efficacy of a single, initial, 200-mg dose and 100 mg twice daily of
minocycline for a total duration of up to 3 months. Patients improved
remarkably quickly. Although single-dose therapy did not result in a
significant killing of Mycobacterium leprae, viable M. leprae were cleared
from the dermis regularly by 3 months of twice-daily therapy, a rate similar
to that achieved by minocycline 100 mg once daily. Because more side effects
were noted herein than previously with 100 mg daily, we recommend that
minocycline, when applied, be administered at 100 mg daily to leprosy
patients.
===================================================
5.) Field trial on efficacy of supervised monthly dose of 600 mg rifampin,
400 mg ofloxacin and 100 mg minocycline for the treatment of leprosy; first
results.
===================================================
Author
Mane I; Cartel JL; Grosset JH
Address
Institut de Leprologie Appliquee, Dakar CD Annexe, Senegal.
Source
Int J Lepr Other Mycobact Dis, 65(2):224-9 1997 Jun
Abstract
In 1995, a field trial was implemented in Senegal in order to evaluate the
efficacy of a regimen based on the monthly supervised intake of rifampin 600
mg, ofloxacin 400 mg and minocycline 100 mg to treat leprosy. During the
first year of the trial, 220 patients with active leprosy (newly
detected or relapsing after dapsone monotherapy) were recruited: 102
paucibacillary (PB) (60 males and 42 females) and 118 multibacillary (MB)
(71 males and 47 females). All of them accepted the new treatment (none
requested to be preferably put under standard WHO/MDT), no clinical sign
which could be considered as a toxic effect of the drug was noted, and none
of the patients refused to continue treatment because of any clinical
trouble. The compliance was excellent: the 113 patients (PB and MB) detected
during the first 6 months of the trial have taken six monthly doses in 6
months, as planned. The rate of clearance and the progressive decrease of
cutaneous lesions was satisfactory. Although it is too soon to give
comprehensive results, it should be noted that no treatment failure was
observed in the 56 PB patients who have completed treatment and have been
followed up for 6 months. The long-term efficacy of the new regimen is to be
evaluated on the rate of relapse during the years following the
cessation of treatment. If that relapse rate is acceptable (similar to that
observed in patients after treatment with current standard WHO/ MDT), the
new regimen could be a solution to treat, for instance, patients very
irregular and/or living in remote or inaccessible areas since no selection
of rifampin-resistant Mycobacterium leprae should be possible (a monthly
dose of ofloxacin and minocycline being as effective as a dose of dapsone
and clofazimine taken daily for 1 month). Nevertheless, until longer term
results of this and other trials become available, there is no justification
for any change in the treatment strategy, and all leprosy patients should be
put under standard WHO/MDT.
====================================================
6.) Bactericidal activity of a single-dose combination of ofloxacin plus minocycline, with or without rifampin, against Mycobacterium leprae in mice and in lepromatous patients.
6.) Bactericidal activity of a single-dose combination of ofloxacin plus minocycline, with or without rifampin, against Mycobacterium leprae in mice and in lepromatous patients.
====================================================
Author
Ji B; Sow S; Perani E; Lienhardt C; Diderot V; Grosset J
Address
Facult´e de M´edecine Piti´e-Salp^etri`ere, Paris, France.
bacterio@biomath.jussieu.fr
Source
Antimicrob Agents Chemother, 42(5):1115-20 1998 May
Abstract
To develop a fully supervisable, monthly administered regimen for treatment
of leprosy, the bactericidal effect of a single-dose combination of
ofloxacin (OFLO) and minocycline (MINO), with or without rifampin (RMP),
against Mycobacterium leprae was studied in the mouse footpad system and in
previously untreated lepromatous leprosy patients. Bactericidal activity was
measured by the proportional bactericidal method. In mouse experiments, the
activity of a single dose of the combination OFLO-MINO was dosage related;
the higher dosage of the combination displayed bactericidal activity which
was significantly inferior to that of a single dose of RMP, whereas the
lower dosage did not exhibit a bactericidal effect. In the clinical trial,
20 patients with previously untreated lepromatous leprosy were treated with
a single dose consisting of either 600 mg of RMP plus 400 mg of OFLO and 100
mg of MINO or 400 mg of OFLO plus 100 mg of MINO. The OFLO-MINO combination
exhibited definite bactericidal activity in 7 of 10 patients but was less
bactericidal than the RMP-OFLO-MINO combination. Both combinations were well
tolerated. Because of these promising results, a test of the efficacy of
multiple doses of ROM in a larger clinical trial appears justified.
====================================================
7.)Efficacy of single dose multidrug therapy for the treatment of single-lesion paucibacillary leprosy. Single-lesion Multicentre Trial Group.
7.)Efficacy of single dose multidrug therapy for the treatment of single-lesion paucibacillary leprosy. Single-lesion Multicentre Trial Group.
====================================================
Source
Indian J Lepr, 69(2):121-9 1997 Apr-Jun
Abstract
A multicentre double-blind controlled clinical trial was carried out to
compare the efficacy of a combination of rifampicin 600 mg plus ofloxacin
400 mg plus minocycline 100 mg (ROM) administered as single dose with that
of the standard six-month WHO/MDT/PB regimen. The subjects included 1483
cases with one skin lesion who were previously untreated, were
smear-negative, and had no evidence of peripheral nerve trunk involvement,
and they were randomly divided into study and control groups. The total
duration of the study from the day of intake was 18 months, and 1381
patients completed study. Only 12 patients were categorized as treatment
failure and no difference was observed between the two regimens. Occurrence
of mild side-effects and leprosy reactions were minimal (less than 1%) in
both groups. This study showed that ROM is almost as effective as the
standard WHO/MDT/PB in the treatment of single lesion PB leprosy.
====================================================
8.) Bactericidal activity of single dose of clarithromycin plus minocycline, with or without ofloxacin, against Mycobacterium leprae in patients.
8.) Bactericidal activity of single dose of clarithromycin plus minocycline, with or without ofloxacin, against Mycobacterium leprae in patients.
====================================================
Author
Ji B; Jamet P; Perani EG; Sow S; Lienhardt C; Petinon C; Grosset JH
Address
Facult´e de M´edecine Piti´e-Salp^etri`ere, Paris, France.
Source
Antimicrob Agents Chemother, 40(9):2137-41 1996 Sep
Abstract
Fifty patients with newly diagnosed lepromatous leprosy were allocated
randomly to one of five groups and treated with either a month-long standard
regimen of multidrug therapy (MDT) for multibacillary leprosy, a single dose
of 600 mg of rifampin, a month-long regimen with the dapsone (DDS) and
clofazimine (CLO) components of the standard MDT, or a single dose of 2,000
mg of clarithromycin (CLARI) plus 200 mg of minocycline (MINO), with or
without the addition of 800 mg of ofloxacin (OFLO). At the end of 1 month,
clinical improvement accompanied by significant decreases of morphological
indexes in skin smears was observed in about half of the patients of each
group. A significant bactericidal effect was demonstrated
in the great majority of patients in all five groups by inoculating the
footpads of mice with organisms recovered from biopsy samples obtained
before and after treatment. Rifampin proved to be a bactericidal drug
against Mycobacterium leprae more potent than any combination of the other
drugs. A single dose of CLARI-MINO, with or without OFLO, displayed a
degree of bactericidal activity similar to that of a regimen daily of doses
of DDS-CLO for 1 month, suggesting that it may be possible to replace the
DDS and CLO components of the MDT with a monthly dose of CLARI-MINO, with or
without OFLO. However, gastrointestinal adverse events were quite frequent
among patients treated with CLARI-MINO, with or without OFLO, and
may be attributed to the higher dosage of CLARI or MINO or to the
combination of CLARI-MINO plus OFLO. In future trials, therefore, we propose
to reduce the dosages of the drugs to 1,000 mg of CLARI, 100 mg of MINO, and
400 mg of OFLO.
=====================================================================
9.) Chronic Lyme borreliosis at the root of multiple sclerosis--is a cure
with antibiotics attainable?
=====================================================================
Med Hypotheses. 2005;64(3):438-48.
Fritzsche M1.
Author information
1
Clinic for Internal and Geographical Medicine, Soodstrasse 13, 8134
Adliswil, Switzerland. markus.fritzsche@gmx.ch
Abstract
Apart from its devastating impact on individuals and their families,
multiple sclerosis (MS) creates a huge economic burden for society by mainly
afflicting young adults in their most productive years. Although effective
strategies for symptom management and disease modifying therapies have
evolved, there exists no curative treatment yet. Worldwide, MS prevalence
parallels the distribution of the Lyme disease pathogen Borrelia (B.)
burgdorferi, and in America and Europe, the birth excesses of those
individuals who later in life develop MS exactly mirror the seasonal
distributions of Borrelia transmitting Ixodes ticks. In addition to known
acute infections, no other disease exhibits equally marked epidemiological
clusters by season and locality, nurturing the hope that prevention might
ultimately be attainable. As minocycline, tinidazole and hydroxychloroquine
are reportedly capable of destroying both the spirochaetal and cystic L-form
of B. burgdorferi found in MS brains, there emerges also new hope for those
already afflicted. The immunomodulating anti-inflammatory potential of
minocycline and hydroxychloroquine may furthermore reduce the Jarisch
Herxheimer reaction triggered by decaying Borrelia at treatment initiation.
Even in those cases unrelated to B. burgdorferi, minocycline is known for
its beneficial effect on several factors considered to be detrimental in MS.
Patients receiving a combination of these pharmaceuticals are thus expected
to be cured or to have a longer period of remission compared to untreated
controls. Although the goal of this rational, cost-effective and potentially
curative treatment seems simple enough, the importance of a scientifically
sound approach cannot be overemphasised. A randomised, prospective, double
blinded trial is necessary in patients from B. burgdorferi endemic areas
with established MS and/or Borrelia L-forms in their cerebrospinal fluid,
and to yield reasonable significance within due time, the groups must be
large enough and preferably taken together in a multi-centre study.
=====================================================================
10.) In-vitro and in-vivo antibiotic susceptibilities of Lyme disease
Borrelia isolated in China.
====================================================================
J Infect Chemother. 2000 Mar;6(1):65-7.
Li M1, Masuzawa T, Wang J, Kawabata M, Yanagihara Y.
Author information
1
International Center for Medical Research, Kobe University School of
Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650, Japan. muqingl@kobe-u.ac.jp
Abstract
The antibiotic susceptibilities of seven Borrelia burgdorferi sensu lato
isolates from Ixodes persulcatus in China were examined by in-vitro
microdilution minimum inhibition concentration (MIC) and macrodilution
minimum bactericidal concentration (MBC) methods. All isolates tested were
susceptible to amoxicillin, erythromycin, and minocycline. The MICs of these
drugs for the Chinese isolates were 0.025-0.1 microg/ml, <0.012-0.05
microg/ml, and <0.012-0.05 microg/ml, respectively. The MBCs were
0.1-0.39 microg/ml, <0.012-0.2 microg/ml, and 0.025-0.39 microg/ml,
respectively. The in-vivo antimicrobial susceptibilities of the Chinese
Borrelia isolates to two test drugs, amoxicillin and minocycline, were
evaluated using ddY mice. Mice were infected by subcutaneous inoculation
into the right hind footpad. When infection was confirmed, the mice were
treated by subcutaneous injection of the test drugs into the back.
Amoxicillin and minocycline, which possessed high in-vitro activities
against Lyme disease Borrelia, provided good protection against borreliosis
in this animal model. Higher doses of these drugs resulted in elimination of
the Lyme disease spirochete from all animals receiving this course of
treatment. The 50% curative doses (CD50) of amoxicillin and minocycline were
8.7 mg/kg and 3.1 mg/kg, respectively. This suggested that amoxicillin and
minocycline could be useful for the treatment of Chinese Borrelia infection.
=====================================================================
11.) Erythema migrans: three weeks treatment for prevention of late Lyme
borreliosis.
====================================================================
Infection. 1996 Jan-Feb;24(1):69-72.
Breier F1, Kunz G, Klade H, Stanek G, Aberer E.
Author information
1
Universitätsklinik für Dermatologie, Wien, Austria.
Abstract
An open, randomized, prospective study was carried out to compare the
clinical efficacy and safety of phenoxymethylpenicillin with that of
minocycline in the treatment of erythema migrans. Sixty patients
(minocycline 30, penicillin 30) were enrolled in the study. The two groups
of patients were statistically homogeneous regarding age and sex
distribution. IgG and IgM antibodies against Borrelia burgdorferi were
determined by ELISA before and after treatment and 1 year thereafter.
Thirty-nine patients completed the study. All these patients (penicillin 21,
minocycline 18) who received a 21-day course of treatment were free of
clinical symptoms of late Lyme borreliosis after 1 year. Serum antibodies
against B. burgdorferi could be detected before treatment in 6/21 patients
treated with penicillin and 3/18 patients treated with minocycline. After 1
year 8/39 patients were seropositive without any evidence of ongoing
disease. In the remaining 21 patients treatment could not be completed with
the initial antibiotic due to side effects (penicillin 9/30, minocycline
12/30). One patient, who stopped penicillin treatment at day 14 and one
patient who stopped minocycline at day 4, developed fatigue and memory
impairment within the observation period. A 3-week course of treatment with
penicillin or minocycline is equally effective in treating patients with
erythema migrans and preventing late symptoms of Lyme borreliosis.
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12.) No detection of Borrelia burgdorferi-specific DNA in erythema migrans
lesions after minocycline treatment.
=====================================================================
Arch Dermatol. 1995 Jun;131(6):678-82.
Muellegger RR1, Zoechling N, Soyer HP, Hoedl S, Wienecke R, Volkenandt M,
Kerl H.
Author information
1
Department of Dermatology, Karl-Franzens University, Graz, Austria.
Abstract
BACKGROUND AND DESIGN:
Early treatment of erythema migrans is important to prevent late
complications. Minocycline possesses several attributes, making it
potentially useful in the treatment of borrelial infections. In our study,
minocycline was administered to 14 patients with erythema migrans. Punch
biopsy specimens were obtained from the (affected) skin of all patients
before and after therapy. The formalin-fixed, paraffin-embedded specimens
were analyzed by polymerase chain reaction for the presence of Borrelia
burgdorferi-specific DNA.
RESULTS:
Polymerase chain reaction assay succeeded in amplifying B
burgdorferi-specific DNA from the first biopsy specimen, obtained from the
border of erythema migrans before initiating treatment, in eight (57%) of 14
patients. At the end of minocycline therapy, however, polymerase chain
reaction analysis disclosed no B burgdorferi-specific DNA in any of the 14
patients. The good clinical response of our patients with erythema migrans
substantiates our molecular findings.
CONCLUSIONS:
The presented polymerase chain reaction data, together with the clinical
outcome, indicate that minocycline may be useful for treatment of early Lyme
borreliosis.
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13.) Susceptibility of the Lyme disease spirochete to seven antimicrobial
agents.
=====================================================================
Yale J Biol Med. 1984 Jul-Aug;57(4):549-53.
Johnson SE, Klein GC, Schmid GP, Feeley JC.
Abstract
The antimicrobial susceptibility of five Lyme disease spirochete strains
(two human and three tick isolates) was determined. A macrodilution broth
technique was used to determine on three separate test occasions the minimal
inhibitory concentrations (MICs) of seven antibiotics. The Lyme disease
spirochete was most susceptible to erythromycin with a MIC of less than or
equal to 0.06 micrograms/ml. The spirochete was also found to be susceptible
to minocycline, ampicillin, doxycycline, and tetracycline-HCL with
respective mean MICs of less than or equal to 0.13, less than or equal to
0.25, less than or equal to 0.63, and less than or equal to 0.79
micrograms/ml. The spirochete was moderately susceptible to penicillin G
with a mean MIC of 0.93 micrograms/ml. All strains were resistant to
rifampin at the highest concentration tested (16.0 micrograms/ml).
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14.) Antibiotic therapy in early erythema migrans disease and related
disorders.
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Zentralbl Bakteriol Mikrobiol Hyg A. 1987 Feb;263(3):377-88.
Weber K, Neubert U, Thurmayr R.
Abstract
Between December 1978 and July 1985, we used various antibiotics for the
treatment of 97 adult patients with early erythema migrans disease (EMD).
Six patients with borrelial lymphocytoma (BL) and 20 with acrodermatitis
chronica atrophicans (ACA) were treated similarly. Follow-up was for a
median of 20, 14, and 12 months, respectively. The erythema migrans and all
associated symptoms resolved within a median of 3 weeks (0.5-18.4), BL
within 7 weeks (4-16), and ACA partly or completely within several months. A
Jarisch-Herxheimer (-like) reaction was observed in 8 patients with EMD.
Fourteen patients with EMD and one with ACA developed an exacerbation of
symptoms or new manifestations between the 2nd and 20th day, and 28 patients
with EMD and one with ACA continued to have or acquired various symptoms
greater than or equal to 3 weeks after initiation of therapy. Arthralgia,
neurologic and constitutional symptoms, and in one instance a slight
pulmonary interstitial edema developed in EMD. More severe initial illness
was a risk factor for the development of later symptoms in EMD. Retreatment
was more often necessary in ACA than in EMD. A patient with ACA had a
recurrence after 5 1/2 years. IgG antibody titers rose at least fourfold in
5 patients with ACA and in 1 with EMD despite therapy. We tentatively
recommend minocycline or high doses of parenteral penicillin for the
treatment of these disorders.
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