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Time for a Different Approach to Lyme Disease and Long-Term Symptoms

List of authors.
  • Michael T. Melia, M.D.,
  • and Paul G. Auwaerter, M.D.

The condition of most patients with Lyme disease improves after initial antibiotic therapy; however, 10 to 20% of treated patients may have lingering symptoms of fatigue, musculoskeletal pains, disrupted sleep, and lack of customary mental functions. The plausible idea that additional antimicrobial therapy for potentially persistent bacterial infection would foster improvement has been a touchstone of hope in the 40 years since discovery of the disease in the mid-1970s. Patients with long-standing symptoms and well-documented, previously treated Lyme disease have been the focus of a number of randomized, placebo-controlled studies in North America that assessed whether additional antibiotic therapy offers . . .

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Funding and Disclosures

Disclosure forms provided by the authors are available with the full text of this article at NEJM.org.

Author Affiliations

From the Sherrilyn and Ken Fisher Center for Environmental Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore.