Antibiotic therapy in Lyme disease.
Antibiotic therapy in Lyme disease.
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莱姆病的抗生素治疗。
DOI：
10.7326/0003-4819-93-1-1
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发表时间：
1980
影响因子：
39.2
通讯作者：
N. H. Bartenhagen
中科院分区：
文献类型：
--
作者：
A. Steere;S. Malawista;J. Newman;P. Spieler;N. H. Bartenhagen
我们研究了113例莱姆病首发表现慢性移行性红斑的抗生素疗效。慢性迁移性红斑及其相关症状在给予青霉素或四环素的患者（中位持续时间分别为4天和2天）比未给予治疗的患者（10天；P分别小于0.001和P = 0.005）缓解得更快。红霉素对患者无显著影响。尽管在所有四组中，随后出现神经系统和心脏异常的频率相似，但给予青霉素的患者发生关节炎的人数明显少于未给予青霉素的患者（P = 0.001）。在随访至少29个月的15例关节炎患者中，接受青霉素治疗的患者关节受损伤的总持续时间（中位数，4周）短于未接受青霉素治疗的患者（17周；P = 0.019）。尽管该疾病的临床表现可能每年发生频率波动，并影响明显的抗生素效果，但我们认为青霉素治疗可缩短慢性迁移性红斑的持续时间，并可预防或减轻随后的关节炎。
We studied antibiotic efficacy in 113 patients with erythema chronicum migrans, the first manifestation of Lyme disease. Erythema chronicum migrans and its associated symptoms resolved faster in patients given penicillin or tetracycline (median duration, 4 and 2 days, respectively) than in untreated patients (10 days; P less than 0.001 and P = 0.005, respectively). Erythromycin had no significant effect. Although the frequency of subsequent neurologic and cardiac abnormalities was similar in all four groups, significantly fewer patients given penicillin developed arthritis than did untreated patients (P = 0.001). Among 15 patients with arthritis who were followed for at least 29 months, the total duration of joint involvement was shorter in penicillin-treated patients (median, 4 weeks) than in untreated patients (17 weeks; P = 0.019). Although the clinical manifestations of the disease may fluctuate in frequency from year to year and influence apparent antibiotic effect, we conclude that penicillin therapy shortens the duration of erythema chronicum migrans and may prevent or attenuate subsequent arthritis.