Overuse of antibiotics has triggered a resistance crisis that could seriously threaten public health for decades to come. When antibiotics are prescribed too often, or for far too long, microbes resistant to conventional treatments remain and multiply, resulting in the spread of these superbugs. In an effort to reduce reliance on antibiotics, researchers all over the world have made it their mission to challenge the effectiveness of short and long term antibiotic treatments. During one of these important investigations, researchers found that long-term antibiotic treatments for Lyme disease are not superior to short term alternatives.
Participants
For this study, researchers sought participants suffering from chronic Lyme disease symptoms, including pain, cognitive difficulties and fatigue. The patients had to prove that their symptoms linked back to the development of the telltale erythema migrans rash, the presence of B. burgdorferi bacteria in their body or a definitive Lyme disease diagnosis obtained through other means.
Researchers randomly split the 280 study participants into three even groups. All participants received a short term course of antibiotics during the first two weeks of the study. Afterward, one group unknowingly received placebos, while the other two groups were prescribed one of two oral antibiotics. For these two groups, the oral antibiotics were continued for 12 full weeks for a total of 14 weeks of antimicrobial treatment.
Measurements
At regular intervals, all participants completed detailed questionnaires about their health and overall quality of life. The severity scales for each listed symptom allowed researchers to gauge the effectiveness of the given treatments. Researchers closely analyzed the results to determine the level of symptom improvement for every participant and each group as a whole. The results were analyzed and compared to earlier findings through every step of the process to identify unnatural deviations.
Compliance
Since researchers are highly aware of the risks of ending antibiotic treatment early, great effort went into ensuring patients continued the specified treatment until the given end date. One effective method was the use of electronic bottle caps to record patient compliance with the daily requirements for the study.
Patients only discontinued participation in the study after suffering a serious adverse event. To control for the missing data from these participants, researchers utilized imputation techniques while making the necessary calculations. This statistic analyzation technique ensured the recorded measurements accurately reflected the proposed treatments.
Adverse Effects
Throughout the study, most of the participants suffered minor adverse effects from both the short and long term course of antibiotics. In fact, just over 70% of the participants, or 205 individuals, reported at least one minor side effect during the antibiotic treatment period. Of these minor side effects, photosensitivity, rashes and gastric distress were reported most often. Furthermore, 28 participants suffered serious adverse effects, including severe allergic reactions. Of these individuals, 19 elected to drop out of the study before its intended conclusion.
Findings
Researchers found that study participants did not receive a notable improvement in symptom severity or duration from undergoing long term antibiotic treatments. The group that received a short term course of antibiotics exhibited just as much symptom improvement as the two groups receiving the full 14 weeks of treatment.
Researchers involved in this study hope their findings will help end the discourse about the suitability of long term antibiotic treatments for Lyme disease patients. By proving the ineffectiveness of this course of treatment, doctors can avoid prescribing unnecessary, and potentially harmful, antibiotic treatments to these chronic disease sufferers. Unfortunately, the short course of antibiotics will likely need to remain a part of the treatment protocol to eliminate the presence of bacteria, like B. burgdorferi, commonly spread by ticks.