IMPROVEMENT OF TREATMENT OF PATIENTS WITH LYME BORRELIOSIS DEPENDING ON THE STAGE OF THE DISEASE
DOI:
https://doi.org/10.11603/1681-2727.2026.1.16161Keywords:
Lyme disease, Borrelia burgdorferi, clinical stages, erythema migrans, fatigue, headache, muscle pain, joint pain, symptoms, treatmentAbstract
The issue of treatment of patients with Lyme borreliosis is an urgent problem of modern infectious diseases. One of the directions for solving this problem is to improve the treatment of patients with Lyme borreliosis, depending on the stage of the disease.
The aim of the work is to optimize the duration of etiotropic treatment of patients with erythema migrans in Lyme borreliosis depending on the stage of the disease.
Patients and methods. We examined 49 patients with early stage LB with skin lesions in the form of EM. Among the patients, there were significantly more women than men – 69.4% versus 30.6%, p<0.05. Patients were treated as outpatients and inpatients during 2023-2025 at the Ternopil Regional Clinical Dermatological and Venereological Dispensary. Patients were prescribed the antibacterial drug doxycycline hydrochloride orally, 100 mg twice a day for 21 days. In addition to etiotropic treatment, patients also received enterol 250 (lyophilized saccharomyces boulardii CNCM I-745, 250 mg) 1 sachet 2 times a day and Silybi mariani fructus extractum siccum, 2 tablets 3 times a day per os, the same duration as the antibiotic.The effectiveness of the treatment in the examined patients was assessed on the 8th, 15th and 22nd days from the start of therapy according to the dynamics of the main symptom of the early local stage of LB – EM and other manifestations of LB.
Results. All 49 patients with the early stage of LB were diagnosed with erythema migrans (EM); headache was noted by 8.2% of people, 10.2% complained of arthralgia, 10.2% – myalgia, 14.3% – fatigue. Subsequently, all 49 patients with the early stage of LB were divided into two groups. Group 1 consisted of 28 patients with only skin lesions in the form of EM (early localized stage), group 2 – 21 patients with EM combined with other symptoms (headache, joint pain, muscle and fatigue), (early disseminated stage). It was found that in patients of group 1 (early localized stage) after complex treatment using the antibacterial drug doxycycline hydrochloride, enterol 250 and silybi mariani fructus extractum siccum, a complete clinical response was obtained after 14 days of therapy. At the same time, in patients of group 2 (early disseminated stage of LB) during this period after the indicated complex treatment, a complete clinical response was not achieved. Only after a 21-day course of the prescribed treatment was a complete clinical response noted in all patients of this group.
Conclusions. For patients in the early localized stage of Lyme borreliosis (EM only), it is sufficient to prescribe doxycycline hydrochloride for 14 days. Patients in the early disseminated stage of Lyme disease (EM + complaints of headache, fatigue, joint and muscle pain) should be treated with doxycycline hydrochloride for 21 days.
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Copyright (c) 2026 M. I. Shkilna, M. A. Andreychyn, O. O. Zhuk, O. L. Ivakhiv, M. T. Huk
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Accepted 2026-04-18
Published 2026-04-20
