Abstract
AbstractLyme disease (LD) results from the most prevalent tick-borne infection in North America, with over 476,000 estimated cases annually. The disease is caused byBorrelia burgdorferi (Bb)which transmits through the bite of Ixodid ticks. Most cases treated soon after infection are resolved by a short course of oral antibiotics. However, 10-20% of patients experience chronic symptoms because of delayed or incomplete treatment, a condition called Post-Treatment Lyme Disease (PTLD). SomeBbpersists in PTLD patients after the initial course of antibiotics and an effective treatment to eradicate the persistentBbis needed. Other organisms that cause persistent infections, such asM. tuberculosis, are cleared using a combination of therapies rather than monotherapy. A group of Food and Drug Administration (FDA)-approved drugs efficacious againstBbwere used in monotherapy or in combination in mice infected withBb. Different methods of detection were used to assess the efficacy of the treatments in the infected mice including culture, xenodiagnosis, and molecular techniques. None of the monotherapies eradicated persistentBb. However, 4 dual combinations (doxycycline + ceftriaxone, dapsone + rifampicin, dapsone + clofazimine, doxycycline + cefotaxime) and 3 triple combinations (doxycycline + ceftriaxone+ carbomycin, doxycycline + cefotaxime+ loratadine, dapsone+ rifampicin+ clofazimine) eradicated persistentBbinfections. These results suggest that combination therapy should be investigated in preclinical studies for treating human Lyme disease.
Publisher
Cold Spring Harbor Laboratory
Cited by
1 articles.
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