Summary
A controlled clinical study was set up to examine whether penicillin G sodium (PG) or ceftriaxone (C) is superior in the treatment of acute neuroborreliosis in childhood. Within a time period of 18 months 77 children with symptoms indicative of Lyme borreliosis of the central nervous system (CNS) were seen. In 23 of these childrenBorrelia burgdorferi specific cerebrospinal fluid (CSF) parameters confirmed the diagnosis of a neuroborreliosis. These children were treated at random with intravenous (i.v.) PG 400,000 – 500,000 I.U./kg/day for 14 days (group I) or with i.v. ceftriaxone 75–93 mg/kg/day for 14 days (group II), respectively. Clinical examination and a set of diagnostic laboratory parameters were done at admission, right after therapy, three, six and partly 12 months after therapy. The general condition of all children in both groups improved dramatically during antibiotic therapy, and no relapse occurred within the observation period. Considering the clear and comparable decrease ofB. burgdorferi serum titres and the clinical outcome (duration of disease and follow-up for at least six months) in children of both groups no difference between both antibiotic drugs can be demonstrated.
Zusammenfassung
Eine kontrollierte klinische Studie wurde durchgeführt, um zu überprüfen, ob eine Überlegenheit eines der beiden Präparate: Penicillin-G Natrium oder Ceftriaxon in der Behandlung der akuten Neuroborreliose im Kindesalter besteht. In einem Zeitraum von 18 Monaten wurden 77 Kinder beobachtet, deren Symptomatik den Verdacht auf eine Lyme-Borreliose des Zentralnervensystems erweckte. Bei 23 Kindern wurde der Verdacht mittels spezifischerBorrelia burgdorferi-Parameter aus dem Liquor cerebrospinalis bestätigt. Diese Kinder wurden bezüglich der antibiotischen Therapie randomisiert. Gruppe I wurde mit PG (400.000 – 500.000 I.E./kg Körpergewicht und Tag für 14 Tage) und Gruppe II mit Ceftriaxon (75 – 93 mg/kg Körpergewicht und Tag für 14 Tage) intravenös behandelt. Neben einer klinischen Untersuchung wurde zum Zeitpunkt der Spitalsaufnahme, direkt nach Therapie, sowie drei, sechs und teilweise 12 Monate nach Therapie eine Reihe von Laborparametern geprüft. Bei Betrachtung des klaren und zwischen beiden Gruppen gut vergleichbaren Abfalles derB. burgdorferi-Serum-Titer und des klinischen Verlaufes (Krankheitsdauer und Weiterbeobachtung über wenigstens sechs Monate) ist kein Unterschied zwischen beiden Antibiotika erkennbar. Alle Kinder beider Gruppen zeigten eine rasche Besserung ihres Allgemeinzustandes während der Therapie, ein Rückfall wurde während des Beobachtungszeitraumes nicht beobachtet.
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Müllegger, R.R., Millner, M.M., Spork, K.D. et al. Penicillin G sodium and ceftriaxone in the treatment of neuroborreliosis in children — A prospective study. Infection 19, 279–283 (1991). https://doi.org/10.1007/BF01644967
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DOI: https://doi.org/10.1007/BF01644967