Comparative Study of Azithromycin versus Doxycycline for Treatment of Early

Abstract

Data from European and American authors concerning azithromycin efficacy in the treatment of Lyme borreliosis appear controversial. The aim of this study is to establish whether azithromycin is applicable to patients with early Lyme borreliosis. In these studies a total of 93 patients with clinically defined erythema migrans were enrolled. Forty-nine of them were treated with doxycycline for 14 days and forty-four received azithromycin for 5 days. Physical examinations and serologic investigations by ELISA and Western blot for positive findings were performed at the first visit and repeated 4–6 weeks, 3, 6, and 12 months after starting treatment. Complete resolution of erythema migrans within 14 days after the start of therapy was found in 42 (85,7 %) of 49 doxycycline-treated and in 39 (88,6 %) of 44 azithromycin-treated patients. Incomplete resolution of erythema migrans and/or persistence of minor symptoms (post-Lyme syndrome) for at least 3 months were detected in 6 (12,2 %) of doxycycline-treated and in 4 (9,1 %) of azithromycin -treated patients. One patient in each group (2 % vs. 2,3 %) showed progression of the disease with later manifestations of Lyme borreliosis. Compared to doxycycline, azithromycin possessed equal efficacy for treatment of early Lyme borreliosis. There was no difference in clinical outcome between the two treatment regimens.