Publish Date: 03.12.2018
Category: Outstanding research achievements, Interdisciplinary research, Our contribution to sustainable development goals
Sustainable development goals: 3 Good health and well-being (Indicators)
Despite some differences in the course of both diseases, the outcome of antibiotic treatment is comparable regardless of dissemination and this may be the basis for less invasive treatment of patients with early disseminated Lyme borreliosis in daily clinical practice.
Authors: Daša Stupica, Vera Maraspin, Petra Bogovič, Katarina Ogrinc, Rok Blagus, Tjaša Cerar, Franc Strle
Insufficient data have shown that patients with multiple erythema migrans (MEM), which is a form of early disseminated Lyme borreliosis, have a worse outcome of antibiotic treatment than patients with an early localized form of the disease—solitary erythema migrans (EM). The purpose of the research carried out by the physicians of the University Medical Centre Ljubljana in cooperation with researchers from the Faculty of Medicine of the University of Ljubljana (Daša Stupica, Vera Maraspin, Petra Bogovič, Katarina Ogrinc, Rok Blagus, Tjaša Cerar, Franc Strle) was to identify potential differences in the course and outcome of treatment between MEM and solitary EM.
A prospective cohort study included 200 patients with MEM, 403 patients with solitary EM and 544 control subjects without a history of Lyme borreliosis. They found some differences in the clinical course between the two manifestations of disease. In the first six months after treatment, the proportion of patients with incomplete treatment outcome, characterised predominantly by the presence of new or increased post-Lyme borreliosis symptoms that were clinically difficult to separate from non-specific symptoms also occurring in the general population, was greater in the MEM group than in the solitary EM group, but after 12 months, treatment outcome was comparable. The prevalence of non-specific symptoms in patients was similar to that in control subjects.
The comparable outcome of antibiotic treatment in both patient groups, regardless of dissemination, can be the basis for less invasive treatment of patients with MEM in the routine clinical practice. Critical assessment is required when assessing non-specific symptoms in patients adequately treated for MEM or solitary EM.
Reference: Stupica D., Maraspin-Čarman V., Bogovič P., Ogrinc K., Blagus R., Cerar Kišek T., Strle F., Comparison of Clinical Course and Treatment Outcome for Patients With Early Disseminated or Early Localized Lyme Borreliosis, JAMA Dermatol., 9 (2018), 1050-1056.