7 days of Doxycycline therapy for early Lyme disease as effective as therapy for 14 days

SLOVENIA: According to a study published in The Lancet Infectious Diseases, erythema migrans, the most common symptom of early Lyme borreliosis, can be effectively treated with a shorter oral doxycycline course while also lowering the need for hazardous antibiotics.

The most common vector-borne illness in North America and Europe is Lyme borreliosis. The major treatment guideline for erythema migrans is doxycycline for 10 days.

The authors sought to determine whether oral doxycycline for 7 days is non-inferior to 14 days in treating people with solitary erythema migrans in order to decrease possibly harmful antibiotic misuse by identifying shorter effective therapies.

At the University Medical Center in Ljubljana, Slovenia, the researchers enrolled individuals with a single erythema for this randomised open-label non-inferiority trial. Patients were excluded if they exhibited other Lyme borreliosis symptoms, were pregnant or nursing, immunosuppressed, allergic to doxycycline, or had recently taken medications with anti-borrelial action. Adults received oral doxycycline 100 mg twice daily for 7 or 14 days, according to a 1:1 random distribution. In a per-protocol analysis, the difference in the proportion of patients who experienced treatment failure, as indicated by persistent erythema, new objective Lyme borreliosis symptoms, or borrelial isolation on skin re-biopsy at 2 months, served as the primary efficacy endpoint. Six percentage points made up the non-inferiority margin. All patients who were randomized to the study and were subject to evaluation at the 14-day visit had their safety assessed.