"25 years of experience with Lyme Borreliosis"
http://www.lyme.no/25-years-of-experien ... orreliosis
A quote (but it is more to read on the link):
The question regarding treatment is still a matter of debate, as we all know. Health authorities in almost every country suggest treatment according to guidelines from IDSA in the USA. This happens even though it is clear that the situation is very differing in Europe and USA. In Europe we have at least three substrains, perhaps five or more, of Borrelia that cause human illness. In the USA there is one strain that is dominating. Standard treatment for borreliosis in most countries is 2-4 weeks of monotherapy with ceftriaxone, doxycyklin, or eventually Penicillin V in early stages.
Dr. Bozsik, You have been a pioneer in the development of combined antibiotic therapy for Lyme borreliosis, can you say something about the background for this work? It was obvious that monotherapy in many cases did not give a satisfactory result, and I started to think that the combination of different antibiotics could give a synergistic effect. With the help of colleagues in different Institutes I did some studies In vitro, with different strains of Borrelia in culture. We tested fluoroquinolone in combination with different other antibiotics like doxycyclin, clarithromycin etc. In all cases we saw a marked synergy, even though Dr. Wilske had presented In vitro-results at the Stockholm conference showing that ciprofloxacin was ineffective alone against Borrelia. We also saw that some patients had good effect of their treatment while others did not improve much. Professor Neubert presented results from In-vitro tests, showing that different Borrelia strains had different susceptibility to different types of antibiotics. Some time later, at the conference in Vienna in 2005, it was discussed with Brorson if tinidazole could be an efficient drug to include in the treatment regime, to target the Gemma (spheroplast, “cyst”-like stage).
The principle for the development of my treatment schedule has been to use ciprofloxacin in combination with another antibiotic to utilize the synergistic effect that was demonstrated in the laboratory studies, and in addition to include tinidazole for the Gemma. In our practice we saw that the patients had cyclic variation in their symptoms in periods of 3-4 weeks. The treatment period should last for 2-3 times the duration of the individual cycle for the patient; that is approximately 8 weeks. We experienced that clinical improvement could continue for a long time after ending the treatment, 2-4 moths even 6 monthes after. However, if the symptoms continue or flare up, the patient may need repeated treatment with a different antibiotic. It is important to know what strain of Borrelia the patient is infected with, in order to choose the best antibiotic for the treatment schedule