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Med Mal Infect. 2007 Apr 13;

Lyme borreliosis: follow up criteria after antibiotherapy?

[Article in French]
Christmann D.
Service de maladies infectieuses et tropicales, clinique medicale A, hopitaux universitaires de Strasbourg, 1, place de l'Hopital, 67091 Strasbourg, France.

The post therapeutic follow-up of Lyme borreliosis is managed according to clinical and serological data. The evolution of antibody rates is such that it doesn't constitute the best element to rely on for follow-up.

Indeed, after a sometimes transitory increase of this rate during or after antibiotherapy, the decrease is very slow, sometimes several months, and often incomplete.

The follow-up should thus be made according to clinical symptoms and their resolution. Resolution of some but not all symptoms must lead to discussing two options.

The first is that of administrating a complementary antibiotherapy with a different mode of action than the first antibiotic used.

The second is that this may be due to recontamination, especially in highly endemic zones, given that antibodies present have no protecting effect. In this case, a new antibiotherapy must of course be initiated.
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