Tijdschrift voor geneeskunde vol:58 issue:23 pages:1559-1565
Guidelines for the management and prevention of Lyme-borreliosis
Lyme-borreliosis is a tick transmitted infectious disease caused by the bacterium Borrelia burgdorferi, with various clinical manifestations. In the absence of a pathognomonic skin lesion, the diagnosis is complicated. Borrelia are sensitive to tetracyclines, penicillins and cephalosporins.
The treatment has to be adapted to the clinical manifestation. In this article the guidelines for management and prevention of Lyme-borreliosis from the Infectious Diseases Society of America are presented: for cutaneous manifestations a 2 to 3 week oral therapy with doxycycline, amoxicillin or cefuroxim-axetil is proposed, for neurologic and severe cardiac manifestations a 2 to 4 week intravenous therapy of ceftriaxone or cefotaxime and for Lyme arthritis a 4 week oral therapy with doxycyline, if necessary followed by a repeat oral or intravenous therapy of antibiotics.
The main preventive measure lies in preventing tick bites and in the early removal of the ticks. Currently, there is no place for vaccination in the European context.