Choosing an AntibioticIn acute Lyme disease, the choice of antibiotics should be tailored to the individual and take into account the severity of the disease as well as the patient’s age, ability to tolerate side effects, clinical features, allergy profile, comorbidities, prior exposure, epidemiologic setting and cost. Conversely, persistent and refractory Lyme disease treatment is more likely to include intravenous and/or intramuscular antibiotics. The choices depend in part on the patient’s response to antibiotic therapy and on the success of antibiotics in treating other Lyme disease patients. Therapy usually starts with oral antibiotics, and some experts recommend high dosages. The choice of antibiotic therapy is guided by weighing the greater activity of intravenous antibiotics in the central nervous system against the lower cost and easy administration of oral antibiotics for B. burgdorferi.
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