Treatment for Lyme disease must be tailored to the patient's stage at which the disease is diagnosed & the presentation of symptoms. Diagnosis with co-infections also complicates the choice of treatment protocol, as different co-infections require other specific antibiotics or other types of medications. Antibiotics can successfully treat many cases of Lyme disease, especially if administered in the early stages of disease progression. This is why it is vital to be tick aware & get treatment early. Typically a 4 week course of an oral antibiotic, such as doxycycline, is prescribed as the standard treatment for early Lyme disease. Late-stage Lyme disease is much more complicated.
Prophylactic (preventative) treatment is recommended when a tick bite is discovered in a Lyme endemic area since EM rash is only exhibited in some cases, & serological confirmation requires several weeks before the body produces sufficient antibodies. Given the potential for serious neurological, cardiac, & other complications from disseminated Lyme disease, there is a clear benefit from the risk mitigation of prophylactic treatment.
As many as 20% of those treated with antibiotics have persistent symptoms well beyond the recovery time for a typical infection (that is around 60,000 people per year - 20% of the 300,000 newly infected cases per year). It is not clear if the duration of initial antibiotic therapy has any impact on the rate of symptom persistence. When Lyme disease is first diagnosed beyond the early stage, it may also be more difficult to eradicate with antibiotics. While there is general agreement in the medical community on the persistence of symptoms in some subset of cases, there is no consensus on continued treatment protocols or even the cause of long-term disease.
Some refer to the condition as post-treatment Lyme disease syndrome, implying that the symptoms no longer stem from continuing infection, & others use the term chronic Lyme disease. The appropriate course of treatment & also additional diagnostic tests for possible undiagnosed co-infections, secondary, & autoimmune diseases in such cases should be discussed on an individual basis between the patient & a medical specialist with significant experience in treating cases of late-stage Lyme disease.
Even patients whose symptoms subside with treatment should be aware of the possibility of relapse with Lyme disease. If the same symptoms or new symptoms that are associated with Lyme disease emerge, the patient & medical professionals should consider the possibility that the initial treatment was not successful & that the patient is among the subset of cases where the original course of antibiotics was not effective in permanently treating the infection. For patients in endemic areas, it is difficult to be certain if the return of symptoms is associated with additional tick bite exposure or relapse associated with the previous infection.
Patients on antibiotic therapy should be mindful of the risks to gastrointestinal function from such treatment. Risks & adverse symptoms can be mitigated by daily intake of probiotics containing acidophilus, whether derived from natural sources like yogurt or kefir, or in potentially higher doses from supplements to replenish the “good” bacteria in the GI tract. Always follow the guidelines & treatment path of your medical professional. This information is informative in nature and should not be taken in lieu of medical instructions by your treating doctor. If your treating doctor is dismissive of your ongoing clinical symptoms, seek immediate care from a doctor who has great experience in treating your disease(s) before you may have additional complications.