Weber K, Wilske B, Preac-Mursic V, Thurmayr R
Abteilung für Mikrobiologie, Max von Pettenkofer Institut, Universität München, Germany.
Infection. 1993 Nov-Dec;21(6):367-72. doi: 10.1007/BF01728915.
In a randomized multicenter therapeutic trial, 32 patients with erythema migrans received oral azithromycin 500 mg once daily and 33 patients received phenoxymethylpenicillin (penicillin V) 1 million U three times daily for 10 days. Follow-up was for a median of 17 (range 3-32) months. Four weeks after initiation of therapy, 20 (62%) patients given azithromycin and 17 (51%) patients given penicillin V were completely free of all signs and symptoms and did not develop new ones subsequently (no significant difference). Three months after initiation of therapy, the corresponding figures were 25 (78%) azithromycin and 28 (85%) penicillin V recipients (no significant difference). There were only minor sequelae such as arthralgia, headache, fatigue, stiff neck and dysesthesia. Azithromycin led to a significantly faster resolution of the erythema migrans than penicillin V (p < 0.001). Significantly more patients with more severe compared with mild initial disease had an elevated IgM antibody titer prior to therapy (p < 0.001). Usually mild to moderate side effects occurred in 12 patients given azithromycin and five patients given penicillin V (p < 0.05). Azithromycin appears to be as effective as penicillin V for the treatment of early Lyme borreliosis and it seems to clear the erythema migrans more promptly.
在一项随机多中心治疗试验中，32例游走性红斑患者每天口服一次500毫克阿奇霉素，33例患者每天三次口服100万单位苯氧甲基青霉素（青霉素V），疗程为10天。随访时间中位数为17个月（范围3 - 32个月）。治疗开始四周后，接受阿奇霉素治疗的20例（62%）患者和接受青霉素V治疗的17例（51%）患者所有体征和症状完全消失，且随后未出现新的症状（无显著差异）。治疗开始三个月后，相应数字分别为接受阿奇霉素治疗的25例（78%）和接受青霉素V治疗的28例（85%）（无显著差异）。仅出现如关节痛、头痛、疲劳、颈部僵硬和感觉异常等轻微后遗症。阿奇霉素使游走性红斑的消退速度明显快于青霉素V（p < 0.001）。与轻度初始疾病患者相比，病情较重的患者在治疗前IgM抗体滴度显著升高（p < 0.001）。接受阿奇霉素治疗的12例患者和接受青霉素V治疗的5例患者出现通常为轻至中度的副作用（p < 0.05）。阿奇霉素在治疗早期莱姆病方面似乎与青霉素V一样有效，而且它似乎能更迅速地消除游走性红斑。
