Treatment of Lyme disease

The treatment of an infection with the Borrelia bacteria is usually successful in an early stage. The longer an infection goes untreated, however, the more serious the consequences might become. As treatment, the Dutch guidelines advise taking antibiotics for 10 days to a month, depending on the stage the illness. In most cases, this treatment is enough.

Residual symptoms

However, in practise, it happens that patients still have serious symptoms after treatment. Or that symptoms return after a period of time. When symptoms remain to exist after treatment, these are usually considered ‘residual symptoms’. It is assumed that taking antibiotics is enough to kill the Borrelia bacterium, and further treatment is unnecessary. However, the guidelines do leave a bit of room for the attending general practitioner to deviate from and choose for a longer follow-up treatment when an ongoing infection seems to be present. In most of these cases, antibiotics as tablets or by infusion are used.

Jarisch-Herxheimer reaction

Besides the well-known side effects, the symptoms might become more serious at the start or during the use of antibiotics, which is known as a Jarisch-Herxheimer reaction. It is believed that this reaction means that the treatment with antibiotics is effective. This namely indicates an active infection (which might or might not be caused by the Borrelia bacterium). That is why, it is often decided to continue the treatment. In case of a severe reaction, however, it might be necessary to stop taking the medication or lower the dosage (temporarily).