Therapeutic aspects of Lyme borreliosis

Abstract Lyme borreliosis was treated with antibacterial compounds long before the etiology of the syndrome was established. The first to try was probably Svartz, who in 1946 successfully treated a patient with acrodermatitis chronica atrophicans (ACA) with penicillin. 1 Thyresson completed the work of Svartz by demonstrating the successful treatment of 57 patients with ACA in 1949. 2 In 1951, Hollstrom found that antispirocheticidal drugs were effective in the treatment of erythema migrans (EM). He also found that penicillin was superior to other antispirocheticidal drugs used, such as wismuth, neoarsphenamine (Neosalvarsan), and Oxophenarsine hydrochloride (Mapharside). 3 That same year, Hellerstrom described a patient with EM associated with meningitis who was cured by penicillin in doses that would be considered homeopathic today (60 mg six times daily). 4 In Europe, penicillin was established during the 1950s as an effective treatment for EM and ACA. In the United States, Steere and co-workers in 1980 were able to demonstrate that penicillin and tetracyclines are effective in the treatment of EM, 5 before the etiology of Lyme borreliosis, Borrelia burgdorferi , was established in 1982. 6