Macrolide therapy of chronic Lyme Disease.

by | CIRS, Functional & Integrative Medicine, ISEAI, Lyme Disease & Atypical Infections

https://www.ncbi.nlm.nih.gov/pubmed/14586290

Comment; Great to know of a way to get a leg up on Borrelia, an organism that hides so well, is so difficult to diagnose & treat!

Donta ST1.

Author information

1Boston University Medical Center, 650 Albany Street-8th Floor, Boston, MA 02118, U.S.A. sam.donta@bmc.org

Abstract

BACKGROUND:

Macrolide antibiotics are highly active in vitro against B.burgdorferi, but have limited efficacy in the treatment of patients with Lyme Disease. As macrolides are less active at a low pH, their poor clinical activity might be due to localization of borrelia to an acidic endosome, and their activity improved by alkalinization of that compartment with hydroxychloroquine.

MATERIAL/METHODS:

235 patients with a multi-symptom complex typical of chronic Lyme disease, ie fatigue, musculoskeletal pain, and neurocognitive dysfunction and with serologic reactivity against B.burgdorferi were treated with a macrolide antibiotic (eg clarithromycin) and hydroxychloroquine.

RESULTS:

Eighty % of patients had self-reported improvement of 50% or more at the end of 3 months. After 2 months of treatment, 20% of patients felt markedly improved (75-100% of normal); after 3 months of treatment, 45% were markedly improved. Improvement frequently did not begin until after several weeks of therapy. There were no differences among the three macrolide antibiotics used. Patients who had been on hydroxychloroquine or macrolide antibiotic alone had experienced little or no improvement. Compared to patients ill for less than 3 years, the onset of improvement was slower, and the failure rate higher in patients who were ill for longer time periods.

CONCLUSIONS:

These results support the hypothesis that the Lyme borrelia reside in an acidic endosome and that the use of a lysosomotropic agent augments the clinical activity of macrolide antibiotics in the treatment of patients with chronic Lyme Disease. In contrast, the efficacy of tetracycline in such patients is not affected by hydroxychloroquine.

Dr. Raymond Oenbrink
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