A reappraisal of the u.s. Clinical trials of post-treatment lyme disease syndrome.
A reappraisal of the u.s. Clinical trials of post-treatment lyme disease syndrome.
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DOI：
10.2174/1874205x01206010079
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发表时间：
2012-01-01
期刊：
影响因子：
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通讯作者：
Britton, Carolyn B
中科院分区：
文献类型：
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作者：
Fallon, Brian A;Petkova, Eva;Britton, Carolyn B
未标记：美国已进行四项联邦资助的莱姆综合征治疗后随机安慰剂对照治疗试验。大多数国际治疗指南总结这些试验表明重复抗生素治疗没有急性或持续的益处。本文的目的是确定这一总结性结论是否得到证据支持。 方法：描述了 4 项美国治疗试验的方法和结果，并评估了其批评。结果：4 项美国治疗试验中的 2 项证明了静脉注射头孢曲松对主要和/或次要结局指标的疗效。结论：未来的治疗指南应阐明静脉注射头孢曲松对于治疗抑郁症的疗效。 治疗后莱姆病疲劳在一项随机对照试验中得到证实，并得到第二项随机对照试验的支持，但不推荐使用它，主要是因为静脉注射治疗途径引起的不良事件。虽然重复静脉注射抗生素治疗可能有效，但需要更安全的分娩方式。
UNLABELLED: Four federally funded randomized placebo-controlled treatment trials of post-treatment Lyme syndrome in the United States have been conducted. Most international treatment guidelines summarize these trials as having shown no acute or sustained benefit to repeated antibiotic therapy. The goal of this paper is to determine whether this summary con-clusion is supported by the evidence.METHODS: The methods and results of the 4 U.S. treatment trials are described and their critiques evaluated.RESULTS: 2 of the 4 U.S. treatment trials demonstrated efficacy of IV ceftriaxone on primary and/or secondary outcome measures.CONCLUSIONS: Future treatment guidelines should clarify that efficacy of IV ceftriaxone for post-treatment Lyme fatigue was demonstrated in one RCT and supported by a second RCT, but that its use was not recommended primarily due to adverse events stemming from the IV route of treatment. While repeated IV antibiotic therapy can be effective, safer modes of delivery are needed.