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Treatment failure in erythema migrans — a review

Therapieversagen bei Erythema migrans — eine Übersicht

  • Special Addendum — Part I
  • Therapy And Prophylaxis In Lyme Borreliosis
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Summary

Patients with erythema migrans can fail to respond to antibiotic therapy. Persistent or recurrent erythema migrans, major sequelae such as meningitis and arthritis, survival ofBorrelia burgdorferi and significant and persistent increase of antibody titres againstB. burgdorferi after antibiotic therapy are strong indications of a treatment failure. Most, if not all, antibiotics used so far have been associated with a treatment failure in patients with erythema migrans. Roxithromycin and erythromycin are definitely or probably ineffective. However, doxycycline, amoxicillin, cefuroxime, ceftriaxone, azithromycin and high-dose penicillin V perform comparably well.

Zusammenfassung

Therapieversager können bei der antibiotischen Behandlung von Patienten mit Erythema migrans vorkommen. Hinweise für ein Versagen der Therapie liefern die Persistenz und das Rezidiv des Erythema migrans, das Auftreten von schwereren Spätfolgen wie Meningitis und Arthritis, die Persistenz vonBorrelia burgdorferi und eine signifikante und persistierende Erhöhung der Antikörpertiter gegenüberB. burgdorferi. Die meisten, wenn nicht alle bisher verwendeten Antibiotika ließen sich in einen Zusammenhang mit dem Therapieversagen beim Erythema migrans bringen. Roxithromycin und Erythromycin sind definitiv oder wahrscheinlich unwirksam. Doxycyclin, Amoxicillin, Azithromycin und hochdosiertes Penicillin V sind hingegen als vergleichsweise gut wirksame Antibiotika anzusehen.

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  1. Dermatologische Privatpraxis, Rosenstr. 6, D-80331, München, Germany

    K. Weber

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  1. K. Weber
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Weber, K. Treatment failure in erythema migrans — a review. Infection 24, 73–75 (1996). https://doi.org/10.1007/BF01780663

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