Resources
This collection will be periodically updated to provide a sampling of peer-reviewed and popular press literature on Lyme disease.
Antibiotic Trials for CLD / PTLDS
DeLong AK, Blossom B, Maloney EL, Phillips SE. 2012. Antibiotic retreatment of Lyme disease in patients with persistent symptoms: A biostatistical review of randomized, placebo-controlled, clinical trials. Contemp. Clin. Trials 33:1132–1142.
PMID: 22922244
Abstract Excerpt: “This biostatistical review reveals that retreatment can be beneficial. Primary outcomes originally reported as statistically insignificant were likely underpowered. The positive treatment effects of ceftriaxone are encouraging and consistent with continued infection, a hypothesis deserving additional study. Additional studies of persistent infection and antibiotic treatment are warranted.
Fallon BA, Petkova E, Keilp JG, Britton CB. 2012. A reappraisal of the u.s. Clinical trials of post-treatment lyme disease syndrome. Open Neurol J 6:79–87.
PMID: 23091568
Abstract Excerpt: “2 of the 4 U.S. treatment trials demonstrated efficacy of IV ceftriaxone on primary and/or secondary outcome measures. Future treatment guidelines should clarify that efficacy of IV ceftriaxone for post-treatment Lyme fatigue was demonstrated in one RCT and supported by a second RCT, but that its use was not recommended primarily due to adverse events stemming from the IV route of treatment. While repeated IV antibiotic therapy can be effective, safer modes of delivery are needed.”
Fallon BA, Keilp JG, Corbera KM, Petkova E, Britton CB, Dwyer E, Slavov I, Cheng J, Dobkin J, Nelson DR, Sackeim HA. 2008. A randomized, placebo-controlled trial of repeated IV antibiotic therapy for Lyme encephalopathy. Neurology 70:992–1003.
PMID: 17928580
Abstract Excerpt: “IV ceftriaxone therapy results in short-term cognitive improvement for patients with posttreatment Lyme encephalopathy, but relapse in cognition occurs after the antibiotic is discontinued. Treatment strategies that result in sustained cognitive improvement are needed.”
Donta ST. 2003. Macrolide therapy of chronic Lyme Disease. Med. Sci. Monit. 9:PI136–42.
PMID: 14586290
Abstract Excerpt: “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.”
Kaplan RF, Trevino RP, Johnson GM, Levy L, Dornbush R, Hu LT, Evans J, Weinstein A, Schmid CH, Klempner MS. 2003. Cognitive function in post-treatment Lyme disease: do additional antibiotics help? Neurology 60:1916–1922.
PMID: 12821733
Abstract Excerpt: “Patients with post-treatment chronic Lyme disease who have symptoms but show no evidence of persisting Borrelia infection do not show objective evidence of cognitive impairment. Additional antibiotic therapy was not more beneficial than administering placebo.”
Krupp LB, Hyman LG, Grimson R, Coyle PK, Melville P, Ahnn S, Dattwyler R, Chandler B. 2003. Study and treatment of post Lyme disease (STOP-LD) A randomized double masked clinical trial. Neurology 60:1923–1930.
PMID: 12821734
Abstract Excerpt: “Ceftriaxone therapy in patients with PLS with severe fatigue was associated with an improvement in fatigue but not with cognitive function or an experimental laboratory measure of infection in this study. Because fatigue (a nonspecific symptom) was the only outcome that improved and because treatment was associated with adverse events, this study does not support the use of additional antibiotic therapy with parenteral ceftriaxone in post-treatment, persistently fatigued patients with PLS.”
Klempner MS, Hu LT, Evans J, Schmid CH, Johnson GM, Trevino RP, Norton D, Levy L, Wall D, McCall J, Kosinski M, Weinstein A. 2001. Two controlled trials of antibiotic treatment in patients with persistent symptoms and a history of Lyme disease. N. Engl. J. Med. 345:85–92.
PMID: 11450676
Abstract Excerpt: “There is considerable impairment of health-related quality of life among patients with persistent symptoms despite previous antibiotic treatment for acute Lyme disease. However, in these two trials, treatment with intravenous and oral antibiotics for 90 days did not improve symptoms more than placebo.”
DeLong AK, Blossom B, Maloney EL, Phillips SE. 2012. Antibiotic retreatment of Lyme disease in patients with persistent symptoms: A biostatistical review of randomized, placebo-controlled, clinical trials. Contemp. Clin. Trials 33:1132–1142.
PMID: 22922244
Abstract Excerpt: “This biostatistical review reveals that retreatment can be beneficial. Primary outcomes originally reported as statistically insignificant were likely underpowered. The positive treatment effects of ceftriaxone are encouraging and consistent with continued infection, a hypothesis deserving additional study. Additional studies of persistent infection and antibiotic treatment are warranted.
Fallon BA, Petkova E, Keilp JG, Britton CB. 2012. A reappraisal of the u.s. Clinical trials of post-treatment lyme disease syndrome. Open Neurol J 6:79–87.
PMID: 23091568
Abstract Excerpt: “2 of the 4 U.S. treatment trials demonstrated efficacy of IV ceftriaxone on primary and/or secondary outcome measures. Future treatment guidelines should clarify that efficacy of IV ceftriaxone for post-treatment Lyme fatigue was demonstrated in one RCT and supported by a second RCT, but that its use was not recommended primarily due to adverse events stemming from the IV route of treatment. While repeated IV antibiotic therapy can be effective, safer modes of delivery are needed.”
Fallon BA, Keilp JG, Corbera KM, Petkova E, Britton CB, Dwyer E, Slavov I, Cheng J, Dobkin J, Nelson DR, Sackeim HA. 2008. A randomized, placebo-controlled trial of repeated IV antibiotic therapy for Lyme encephalopathy. Neurology 70:992–1003.
PMID: 17928580
Abstract Excerpt: “IV ceftriaxone therapy results in short-term cognitive improvement for patients with posttreatment Lyme encephalopathy, but relapse in cognition occurs after the antibiotic is discontinued. Treatment strategies that result in sustained cognitive improvement are needed.”
Donta ST. 2003. Macrolide therapy of chronic Lyme Disease. Med. Sci. Monit. 9:PI136–42.
PMID: 14586290
Abstract Excerpt: “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.”
Kaplan RF, Trevino RP, Johnson GM, Levy L, Dornbush R, Hu LT, Evans J, Weinstein A, Schmid CH, Klempner MS. 2003. Cognitive function in post-treatment Lyme disease: do additional antibiotics help? Neurology 60:1916–1922.
PMID: 12821733
Abstract Excerpt: “Patients with post-treatment chronic Lyme disease who have symptoms but show no evidence of persisting Borrelia infection do not show objective evidence of cognitive impairment. Additional antibiotic therapy was not more beneficial than administering placebo.”
Krupp LB, Hyman LG, Grimson R, Coyle PK, Melville P, Ahnn S, Dattwyler R, Chandler B. 2003. Study and treatment of post Lyme disease (STOP-LD) A randomized double masked clinical trial. Neurology 60:1923–1930.
PMID: 12821734
Abstract Excerpt: “Ceftriaxone therapy in patients with PLS with severe fatigue was associated with an improvement in fatigue but not with cognitive function or an experimental laboratory measure of infection in this study. Because fatigue (a nonspecific symptom) was the only outcome that improved and because treatment was associated with adverse events, this study does not support the use of additional antibiotic therapy with parenteral ceftriaxone in post-treatment, persistently fatigued patients with PLS.”
Klempner MS, Hu LT, Evans J, Schmid CH, Johnson GM, Trevino RP, Norton D, Levy L, Wall D, McCall J, Kosinski M, Weinstein A. 2001. Two controlled trials of antibiotic treatment in patients with persistent symptoms and a history of Lyme disease. N. Engl. J. Med. 345:85–92.
PMID: 11450676
Abstract Excerpt: “There is considerable impairment of health-related quality of life among patients with persistent symptoms despite previous antibiotic treatment for acute Lyme disease. However, in these two trials, treatment with intravenous and oral antibiotics for 90 days did not improve symptoms more than placebo.”
Guidelines & Case Studies
Please note: It is not the mandate of The Canadian Lyme Science Alliance to endorse specific treatment protocols. References are provided for information only.
Cameron DJ, Johnson LB, Maloney EL. 2014. Evidence assessments and guideline recommendations in Lyme disease: the clinical management of known tick bites, erythema migransrashes and persistent disease. Expert Rev. Anti Infect. Ther. 12:1103–1135.
PMID: 25077519
Abstract Excerpt: “Evidence-based guidelines for the management of patients with Lyme disease were developed by the International Lyme and Associated Diseases Society (ILADS). The guidelines address three clinical questions – the usefulness of antibiotic prophylaxis for known tick bites, the effectiveness of erythema migrans treatment and the role of antibiotic retreatment in patients with persistent manifestations of Lyme disease.”
Wormser GP, Dattwyler RJ, Shapiro ED, Halperin JJ, Steere AC, Klempner MS, Krause PJ, Bakken JS, Strle F, Stanek G, Bockenstedt L, Fish D, Dumler JS, Nadelman RB. 2006. The clinical assessment, treatment, and prevention of lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases Society of America. Clin. Infect. Dis. 43:1089–134.
PMID: 17029130
Abstract Excerpt: “Evidence-based guidelines for the management of patients with Lyme disease, human granulocytic anaplasmosis (formerly known as human granulocytic ehrlichiosis), and babesiosis were prepared by an expert panel of the Infectious Diseases Society of America. … For each of these Ixodes tickborne infections, information is provided about prevention, epidemiology, clinical manifestations, diagnosis, and treatment.”
Boucher, CB. 2015.Vector Transmitted Infections (VTIs): Challenges and Insights
Presentation.
Part I
Part II
Part III
Abstract: Dr. C. Ben Boucher MD, who treated VTI’s from 2006-2013, saw approximately 200 people with possible infections. This presentation is both an overview of these infections and a synopsis of these encounters.
His presentation differentiates the most frequent VTI’s that were seen: Borreliosis, Bartonellosis and Erlichiosis. He reviews the various tests for these infections, but notes that specific symptom constellations combined with Herxheimer reactions, were more helpful in diagnosis. He also reveals that brain Magnetic Resonance Imaging (MRI) was more diagnostic than serology.
Various treatment modalities are presented and there are a few case presentations.
Part of the presentation involves an independent survey/study of 75 patients performed by Corporate Research Associates, Halifax, NS. This research shows the effectiveness of his treatment interventions.
Finally, there is a summary of his insights with challenges still faced by those with possible VTIs as well as those responsible for treating.
Please note: It is not the mandate of The Canadian Lyme Science Alliance to endorse specific treatment protocols. References are provided for information only.
Cameron DJ, Johnson LB, Maloney EL. 2014. Evidence assessments and guideline recommendations in Lyme disease: the clinical management of known tick bites, erythema migransrashes and persistent disease. Expert Rev. Anti Infect. Ther. 12:1103–1135.
PMID: 25077519
Abstract Excerpt: “Evidence-based guidelines for the management of patients with Lyme disease were developed by the International Lyme and Associated Diseases Society (ILADS). The guidelines address three clinical questions – the usefulness of antibiotic prophylaxis for known tick bites, the effectiveness of erythema migrans treatment and the role of antibiotic retreatment in patients with persistent manifestations of Lyme disease.”
Wormser GP, Dattwyler RJ, Shapiro ED, Halperin JJ, Steere AC, Klempner MS, Krause PJ, Bakken JS, Strle F, Stanek G, Bockenstedt L, Fish D, Dumler JS, Nadelman RB. 2006. The clinical assessment, treatment, and prevention of lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases Society of America. Clin. Infect. Dis. 43:1089–134.
PMID: 17029130
Abstract Excerpt: “Evidence-based guidelines for the management of patients with Lyme disease, human granulocytic anaplasmosis (formerly known as human granulocytic ehrlichiosis), and babesiosis were prepared by an expert panel of the Infectious Diseases Society of America. … For each of these Ixodes tickborne infections, information is provided about prevention, epidemiology, clinical manifestations, diagnosis, and treatment.”
Boucher, CB. 2015.Vector Transmitted Infections (VTIs): Challenges and Insights
Presentation.
Part I
Part II
Part III
Abstract: Dr. C. Ben Boucher MD, who treated VTI’s from 2006-2013, saw approximately 200 people with possible infections. This presentation is both an overview of these infections and a synopsis of these encounters.
His presentation differentiates the most frequent VTI’s that were seen: Borreliosis, Bartonellosis and Erlichiosis. He reviews the various tests for these infections, but notes that specific symptom constellations combined with Herxheimer reactions, were more helpful in diagnosis. He also reveals that brain Magnetic Resonance Imaging (MRI) was more diagnostic than serology.
Various treatment modalities are presented and there are a few case presentations.
Part of the presentation involves an independent survey/study of 75 patients performed by Corporate Research Associates, Halifax, NS. This research shows the effectiveness of his treatment interventions.
Finally, there is a summary of his insights with challenges still faced by those with possible VTIs as well as those responsible for treating.
Popular Press Coverage
Global Warming May Spread Lyme Disease. Brittany Patterson, Scientific American. May 4, 2015.
“Scientists tackle the difficult problem of how climate change aids the spread of the tick-borne disease.”
Health Canada’s new Lyme disease plan: You act, we’ll watch. Anne Kingston, Maclean’s. July 30, 2014.
“Canada is under pressure to show leadership as Lyme spreads, but its ‘action plan’ shows it’s out of touch”
The truth about Lyme disease. Anne Kingston, Maclean’s. March 24, 2014.
“Lyme disease can masquerade as MS, ALS, even dementia, and its numbers are growing. So why is Canada lagging behind in treating it?”
Why One Man Volunteered To Have 8 Blood-Sucking Ticks Attached To His Knee. Katherine Harmon Courage, Prevention. April 14, 2014.
Not concerned about Lyme disease? You might want to rethink that if you ever go outside.
What Is Lyme Disease? New Findings Deepen the Mystery. Jarret Liotta, National Geographic. March 01, 2014.
“A new study that points to sexual transmission has added to the controversy.”
The Global Search for Education: Canada – Ticks. C.M. Rubin, Huffington Post. October 1, 2013.
Global Warming May Spread Lyme Disease. Brittany Patterson, Scientific American. May 4, 2015.
“Scientists tackle the difficult problem of how climate change aids the spread of the tick-borne disease.”
Health Canada’s new Lyme disease plan: You act, we’ll watch. Anne Kingston, Maclean’s. July 30, 2014.
“Canada is under pressure to show leadership as Lyme spreads, but its ‘action plan’ shows it’s out of touch”
The truth about Lyme disease. Anne Kingston, Maclean’s. March 24, 2014.
“Lyme disease can masquerade as MS, ALS, even dementia, and its numbers are growing. So why is Canada lagging behind in treating it?”
Why One Man Volunteered To Have 8 Blood-Sucking Ticks Attached To His Knee. Katherine Harmon Courage, Prevention. April 14, 2014.
Not concerned about Lyme disease? You might want to rethink that if you ever go outside.
What Is Lyme Disease? New Findings Deepen the Mystery. Jarret Liotta, National Geographic. March 01, 2014.
“A new study that points to sexual transmission has added to the controversy.”
The Global Search for Education: Canada – Ticks. C.M. Rubin, Huffington Post. October 1, 2013.
Copyright 2015
