Follow-up on 21 days of antibiotic for Lyme Disease

Question

One month ago I tested positive for Lyme Disease, after going to my internist with a large rash on my shoulder. (The rash turned into a classic bulls-eye over 5 cm wide.) My doctor prescribed 2 weeks of doxycycline. But my friends and I had heard the treatment was longer. So after I searched the CDC and Johns Hopkins website for the standard treatment, I asked for 2 more weeks of antibiotic. My doctor refused and only would prescribe 1 more week for a total of 21 days. (Her reasoning was the extended antibiotic could be harmful to my intestinal flora since I had also taken 10 days of eurythromycin sp? to treat a rapid skin infection that had developed in the rash cellulitis?) It has been over 1 week since my 3 week antibiotic was finished and I am starting to feel very fatigued, somewhat achy and flu like. I am concerned that I didn’t stay on antibiotics long enough. Is there a standard treatment/testing procedure once a patient has finished the initial course of antibiotics? E.g., when should I get re-tested?

Answer

There is no accepted test to verify that the treatment has been successful. The decision to treat with an additional course of antibiotics is based on clinical signs and symptoms.

Alan Matsumoto, M.D.

About Alan Matsumoto, M.D.

Part-time Faculty, Division of Rheumatology
Johns Hopkins University