Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Hospital of Pittsburgh of UPMC, Pennsylvania.
Richard K. Mellon Institute for Pediatric Research, Department of Pediatrics, University of Pittsburgh School of Medicine, Pennsylvania.
J Pediatric Infect Dis Soc. 2019 Jul 1;8(3):272-275. doi: 10.1093/jpids/piy072.
Guidelines for pediatric Lyme meningitis recommend treatment with parenteral therapy [1, 2]. Adult studies suggest that Lyme meningitis can be successfully treated with oral therapy. Our objective was to evaluate the clinical response, side effects and outcome of oral therapy for Lyme meningitis in the pediatric population compared with parenteral therapy in an area endemic for Lyme disease.
We conducted a case series chart review from January 2012 to May 2017 of pediatrics patient diagnosed and treated for Lyme meningitis. We recorded clinical presentation, laboratory values, antimicrobial therapy and follow up after therapy to compare the efficacy of oral versus parenteral route of therapy.
We identified 38 patients diagnosed with Lyme meningitis. Thirty-two patients were discharge with exclusively oral therapy with: doxycycline and amoxicillin. We had only 2 patients developed potential adverse effects from oral doxycycline therapy. All patients treated with oral antibiotics had resolution of symptoms on follow up appointments.
Oral therapy for Lyme meningitis yields no serious adverse events, was well tolerated and showed resolution of symptoms.
小儿莱姆病脑膜炎的指南建议采用静脉治疗[1,2]。成人研究表明，莱姆病脑膜炎可以通过口服治疗成功治疗。我们的目的是评估莱姆病流行地区儿科患者口服治疗莱姆病脑膜炎的临床反应、副作用和结果与静脉治疗相比。
我们对 2012 年 1 月至 2017 年 5 月期间诊断和治疗莱姆病脑膜炎的儿科患者进行了病例系列图表回顾。我们记录了临床表现、实验室值、抗菌治疗以及治疗后的随访，以比较口服与静脉治疗途径的疗效。
我们确定了 38 例莱姆病脑膜炎患者。32 例患者仅接受口服治疗，包括多西环素和阿莫西林。我们只有 2 例患者出现口服多西环素治疗的潜在不良反应。所有接受口服抗生素治疗的患者在随访时症状均得到缓解。
莱姆病脑膜炎的口服治疗没有严重的不良反应，耐受性良好，并显示出症状缓解。
