How long is 'long term' antibiotic treatment ?

Medical topics with questions, information and discussion related to Lyme disease and other tick-borne diseases.
Cobwebby
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How long is 'long term' antibiotic treatment ?

Post by Cobwebby » Mon 3 Sep 2012 16:06

I was treated for two years-is that long term?

Is there any clarification for what constitutes long term?

Is it > 3 months or > 12 months or >24 months or > 3 years?
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Henry
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Re: How long is 'long term' antibiotic treatment ?

Post by Henry » Mon 3 Sep 2012 16:24

A placebo-controlled, double blind study showing EFFICACY by appropriate statistical analysis is required to answer that question. To date, all of the results obtained have been negative, i.e., no beneficial effects have been demonstrated for the term of treatment examined.

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Re: How long is 'long term' antibiotic treatment ?

Post by X-member » Mon 3 Sep 2012 16:53

http://www.lymeneteurope.org/forum/view ... =70#p31132

From the topic above:

Bagge:
Carina, no ethical researcher will design a controlled study to observe the effects of withholding treatment from patients known to have an active infection. It is unethical, aka wrong, to design a study where participants have a fully documented, evidenced case of active Lyme or any other infectious disease and then withhold all treatment while the disease progresses, so as to study the effects and benefits, if any, of initial treatment being administered years after the infection was initiated.
But, you Henry actually claim that a placebo-controlled, double blind study on cases that maybe need a longer term treatment can be done?
Last edited by X-member on Mon 3 Sep 2012 17:17, edited 1 time in total.

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Re: How long is 'long term' antibiotic treatment ?

Post by X-member » Mon 3 Sep 2012 17:00

http://www.lymeneteurope.org/forum/view ... =90#p31145

From the topic/post above:

Rita:
Just as there are European studies comparing the effectiveness of IV Ceftriaxone versus oral doxycycline, or 2 weeks versus 4 weeks of oral doxycyline for early Lyme disease, could this strategy not also apply to late Lyme disease?

I agree that withholding treatment would be unethical, but I'm thinking there are other avenues that could be explored -- if enough people agree to participate. Some folks might actually prefer to be treated for shorter versus longer periods of time.
Bagge:
Good question. People like Henry would be the most qualified to respond, however, I would not expect him or others like him to continue to subject themselves to the types of discussions and serious accusations that people like him have endured here on LNE and throughout the activist community as a whole - reminds me of the expression 'Don't bite the hand that feeds you'. In other words, if one is not in a position to do the research, fund the studies, and do the necessary work on their own, then don't alienate, threaten and intimidate those that are able to do so.

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Re: How long is 'long term' antibiotic treatment ?

Post by X-member » Mon 3 Sep 2012 17:05

Cobwebby:
I was treated for two years-is that long term?

Is there any clarification for what constitutes long term?

Is it > 3 months or > 12 months or >24 months or > 3 years?
If you ask a person on IDSA:s side in this controversy, the answer is probably 28 days.

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Spanky
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Re: How long is 'long term' antibiotic treatment ?

Post by Spanky » Mon 3 Sep 2012 17:12

"Cobwebby":
I was treated for two years-is that long term?
Yes. (And iv, too, wasn't it? You may recall that I asked why and in response, you called me some names).
Is there any clarification for what constitutes long term?
I use the phrase "longterm" or "extended" to mean any treatment in excess of that recommended.

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Re: How long is 'long term' antibiotic treatment ?

Post by X-member » Mon 3 Sep 2012 17:20

From the quote from Bagge (earlier):
no ethical researcher will design a controlled study to observe the effects of withholding treatment from patients known to have an active infection.

You have told us a very, very important thing that maybe can explain some "funny" answers in this forum.

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Re: How long is 'long term' antibiotic treatment ?

Post by X-member » Mon 3 Sep 2012 17:39

But, what do IDSA say about the most common form of late Lyme disease in Europe:

http://cid.oxfordjournals.org/content/4 ... l.pdf+html

A quote:
A controlled study is warranted to compare oral with parenteral antibiotic therapy for the treatment of acrodermatitis chronica atrophicans.
Why do IDSA ask for this, if it is considered to be wrong (unethical) to do studies on late active Lyme infections?

Edit to add:

More information about ACA/B Afzelii can be found here:

http://www.lymeneteurope.org/forum/view ... 176#p31182

Henry
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Re: How long is 'long term' antibiotic treatment ?

Post by Henry » Mon 3 Sep 2012 17:44

Carina: The key phrase is "... to withhold treatment to patients KNOWN to be actively infected". Obviously, it would be unethical to deny antibiotic treatment to patients KNOWN to be actively infected. However, in the case of the 4-NIH supported clinical trials, that was not established. It was assumed that if these patients were actively infected, they would have received some measurable benefit as a result of antibiotic therapy. Furthermore, if a treatment benefit were apparent, the placebo-controls would be provided with antibiotic therapy once a benefit became known and at no charge to the patients. So, there was no violation of standard ethical principles in any of these 4 studies.

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Re: How long is 'long term' antibiotic treatment ?

Post by X-member » Mon 3 Sep 2012 17:47

From an earlier post again:

Bagge:
no ethical researcher will design a controlled study to observe the effects of withholding treatment from patients known to have an active infection.
Henry:

It was assumed that if these patients were actively infected
Read what Bagge said again!

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