LYMEPOLICYWONK: Embers Monkey Study Part 3. IDSA 28 Day Treatment Protocol Fails to Clear Infection.
Early disseminated Lyme disease was defined by the researchers as 4 months after inoculation. For this portion of the study, 5 monkeys were inoculated with Borrelia burgdorferi (Bb), 3 were treated with 28 days of doxycycline after 4 months. At about one year after inoculation, the monkeys intensive tissue sampling was conducted to determine whether Bb persisted notwithstanding treatment. The protocol used was the IDSA’s protocol for early Lyme, in this case 28 days of doxycycline. Persistent infection was found in all five animals.
This means that for monkeys that go untreated for 4 months before beginning treatment, persistent infection after 28 days of treatment is expected. There are studies that show that the IDSA short term protocol is successful for many (but not all) patients who are diagnosed and treated with an EM rash. However, this study–which used 4 months as the threshold for determining early disseminated Lyme disease–had a 100% failure rate.
The Embers study suggests that attempting to use EM rash treatment approaches to patients who have had the illness for even a short while longer is not appropriate. And, it suggests that even for early disseminated cases of Lyme disease, alternative more effective treatment options are needed because standard IDSA protocols do not clear infection.
This article is part of a series of reviewing the Embers findings for treatment of chronic and early disseminated Lyme disease as well as the effectiveness of the C6 antibody test. You can find these other posts here:
Part 1–New study shows Lyme persists in monkeys
Part 2–Treatment and Persistence
Part 3–IDSA 28-day treatment protocol fails to clear infection
Part 4–Lab tests fail to detect Lyme disease
Part 5–Of mice and men and monkeys
Read the journal article here.
References for this post:
Embers ME, Barthold SW, Borda JT, Bowers L, Doyle L, Hodzic E, et al. Persistence of Borrelia burgdorferi in Rhesus Macaques following Antibiotic Treatment of Disseminated Infection. PLoS ONE. 2012;7(1):e29914. Available at:http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0029914
Wormser GP, Dattwyler RJ, Shapiro ED, Halperin JJ, Steere AC, Klempner MS, et al. The clinical assessment, treatment, and prevention of lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis. 2006 Nov 1;43(9):1089-134.
The LYME POLICY WONK blog is written by Lorraine Johnson, JD, MBA, who is the Chief Executive Officer of LymeDisease.org, formerly CALDA. Contact her at lbjohnson@lymedisease.org.
