Borg Rebecca, Dotevall Leif, Hagberg Lars, Maraspin Vera, Lotric-Furlan Stanka, Cimperman Joze, Strle Franc
Department of Infectious Diseases, Sahlgrenska University Hospital, Göteborg, Sweden.
Scand J Infect Dis. 2005;37(6-7):449-54. doi: 10.1080/00365540510027228.
This prospective, open-label, non-randomized trial at the University Departments of Infectious Diseases in Ljubljana, Slovenia, and Göteborg, Sweden, was conducted to compare the kinetics of the cerebrospinal fluid (CSF) mononuclear cell count after 10-14 d of ceftriaxone or doxycycline for treatment of Lyme neuroborreliosis. 29 patients were treated with intravenous ceftriaxone 2 g daily in Ljubljana and 36 patients with oral doxycycline 400 mg daily in Göteborg. The study protocol included lumbar puncture before and 6-8 weeks after treatment initiation. There was a marked decrease (1.2 log10 x 10(6)/l) of the median CSF mononuclear cell count following treatment. With the assumption of a linear regression of the logarithmic mononuclear cell counts between the 2 lumbar punctures, no significant difference between the 2 antibiotic treatments could be found. All patients were clinically much improved after treatment. At 6 months follow-up 23 (79%) of the ceftriaxone- and 26 (72%) of the doxycycline-treated patients were completely recovered. Intravenous ceftriaxone or oral doxycycline was found to be effective, safe, and convenient for treatment of Lyme neuroborreliosis.
在斯洛文尼亚卢布尔雅那和瑞典哥德堡的大学传染病科进行了这项前瞻性、开放标签、非随机试验，以比较头孢曲松或强力霉素治疗莱姆病神经伯氏疏螺旋体病10 - 14天后脑脊液（CSF）单核细胞计数的动力学变化。在卢布尔雅那，29例患者接受每日2 g静脉注射头孢曲松治疗，在哥德堡，36例患者接受每日400 mg口服强力霉素治疗。研究方案包括在治疗开始前及开始后6 - 8周进行腰椎穿刺。治疗后CSF单核细胞计数中位数显著下降（1.2 log10×10⁶/l）。假设两次腰椎穿刺之间对数单核细胞计数呈线性回归，未发现两种抗生素治疗之间有显著差异。所有患者治疗后临床症状均有明显改善。在6个月随访时，头孢曲松治疗组23例（79%）和强力霉素治疗组26例（72%）患者完全康复。结果发现，静脉注射头孢曲松或口服强力霉素治疗莱姆病神经伯氏疏螺旋体病有效、安全且方便。
