Lyme Treatment

• Early Disease

  • doxycycline 100 mg bid for three weeks or
  • amoxicillin 500 tid with probenecid 500 mg for three weeks

• Disseminated disease

  • same

• Late Stage

  • Oral doxycycline, 100 mg twice daily for four weeks or
  • Amoxicillin, 500 mg four times per day, with probenecid, 500 mg four times per day, for four weeks or
  • Intravenous ceftriaxone (Rocephin1fl, 2 g per day for 14 days or
  • Intravenous cefotaxime (Claforang) 2 g every eight hours for 14 days or
  • Intravenous penicillin G, 24 million units daily for 14 days.

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Patients with manifestations of early disease may be treated with oral doxycycline, 100 mg twice daily for three weeks, or amoxicillin, 500 mg orally three times per day, with probenecid, 500 mg three times per day, for three weeks.

)Patients with disseminated disease may be treated with oral doxycycline, 100 mg twice daily for three weeks, or

amoxicillin, 500 mg orally three times per day, with probenecid, 500 mg orally three times per day, for three weeks.

)Patients with late-stage disease may be treated with one of the following regimens: (1) Oral doxycycline, 100 mg twice daily for four weeks. (2) Amoxicillin, 500 mg four times per day, with probenecid, 500 mg four times per day, for four weeks. (3) Intravenous ceftriaxone (Rocephin1fl, 2 g per day for 14 days. (4) Intravenous cefotaxime (Claforang) 2 g every eight hours for 14 days. (5) Intravenous penicillin G, 24 million units daily for 14 days.

6. Prognosis.

)Early- or disseminated-stage disease usually responds well to oral regimens.

(b) Late-stage disease may require prolonged or repeated oral or intravenous therapy for full remission.