Could Long-term Antibiotic Use Cause More Harm Than Good When Treating Lyme Disease?

According to the National Institute of Allergy and Infectious Diseases, approximately 10-15 percent of people who are treated for medically documented Lyme disease develop persistent or recurrent symptoms of fatigue, musculoskeletal pain and cognitive complaints.

Patients treated with a long-term course of antibiotics for Lyme disease often report continuing symptoms of pain, fatigue, neurological impairment, or joint and muscle aches upon completion of the treatment. These symptoms could be a result of “chronic Lyme disease”, also known as “Post-treatment Lyme Disease Syndrome” (PTLDS).

Dr. John N. Aucott, an infectious disease specialist, explains that PTLDS is a real disorder, though no one knows what’s happening. “A lot of patients have been told they’re not really sick, just tired or depressed,” he added. “But this is not normal fatigue, and it’s not caused by depression.”

Chronic Lyme disease is commonly treated with more rounds of long-term antibiotic therapy. Antibiotic therapy for chronic Lyme disease is based on disputed reports that these patients may harbor hidden reservoirs of the bacteria causing Lyme disease, Borrelia burgdorferi, long after their initial treatment. But researchers who have studied the therapy have found it to be of little or no benefit and may even produce significant risks that could be worse than the illness, including the development of an antibiotic-resistant infection, intractable diarrhea or kidney or liver damage.

According to a review in the journal of Infectious Disease Clinics of North America, four randomized placebo-controlled studies have shown that ongoing antibiotic therapy offers no sustained benefit to patients with post-Lyme Disease Syndrome. These studies also showed a substantial placebo effect and a significant risk of treatment-related adverse events.

The authors stress the importance of utilizing therapies also used with conditions like Chronic Fatigue Syndrome, including good sleep, nutrition, adaptive pacing and, if needed, treatment for depression.

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