Christmann D
Service de maladies infectieuses et tropicales, clinique médicale A, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg, France.
Med Mal Infect. 2007 Jul-Aug;37(7-8):357-9. doi: 10.1016/j.medmal.2006.01.032. Epub 2007 Apr 16.
The post therapeutic follow-up of Lyme borreliosis is managed according to clinical and serological data. The evolution of antibody rates is such that it doesn't constitute the best element to rely on for follow-up. Indeed, after a sometimes transitory increase of this rate during or after antibiotherapy, the decrease is very slow, sometimes several months, and often incomplete. The follow-up should thus be made according to clinical symptoms and their resolution. Resolution of some but not all symptoms must lead to discussing two options. The first is that of administrating a complementary antibiotherapy with a different mode of action than the first antibiotic used. The second is that this may be due to recontamination, especially in highly endemic zones, given that antibodies present have no protecting effect. In this case, a new antibiotherapy must of course be initiated.
莱姆病螺旋体病的治疗后随访是根据临床和血清学数据进行管理的。抗体率的变化情况使其并非随访所依赖的最佳指标。实际上，在抗生素治疗期间或之后，该比率有时会短暂升高，之后下降非常缓慢，有时长达数月，且往往不完全。因此，随访应依据临床症状及其缓解情况进行。部分而非所有症状的缓解必须考虑两种选择。第一种是给予与首次使用的抗生素作用方式不同的补充性抗生素治疗。第二种是这可能归因于再次感染，特别是在高流行区，因为现存抗体没有保护作用。在这种情况下，当然必须开始新的抗生素治疗。
