期刊
ANTIBIOTICS-BASEL
卷 11, 期 7, 页码 -出版社
MDPI
DOI: 10.3390/antibiotics11070912
关键词
dapsone; disulfiram; chronic Lyme disease; Post-Treatment Lyme Disease Syndrome; Babesia; bartonella; persisters; biofilms
资金
- MSIDS Research Foundation (MRF)
Lyme disease and associated co-infections are increasing globally, with a significant proportion of patients developing chronic Lyme disease despite early treatment. High dose pulsed dapsone combination therapy shows promising results in treating resistant Lyme disease and associated co-infections, providing sustained improvement in major symptoms.
Lyme disease and associated co-infections are increasing worldwide and approximately 20% of individuals develop chronic Lyme disease (CLD)/Post-Treatment Lyme Disease Syndrome (PTLDS) despite early antibiotics. A seven- to eight-week protocol of double dose dapsone combination therapy (DDDCT) for CLD/PTLDS results in symptom remission in approximately 50% of patients for one year or longer, with published culture studies indicating higher doses of dapsone demonstrate efficacy against resistant biofilm forms of Borrelia burgdorferi. The purpose of this study was, therefore, to evaluate higher doses of dapsone in the treatment of resistant CLD/PTLDS and associated co-infections. A total of 25 patients with a history of Lyme and associated co-infections, most of whom had ongoing symptoms despite several courses of DDDCT, took one or more courses of high dose pulsed dapsone combination therapy (200 mg dapsone x 3-4 days and/or 200 mg BID x 4 days), depending on persistent symptoms. The majority of patients noticed sustained improvement in eight major Lyme symptoms, including fatigue, pain, headaches, neuropathy, insomnia, cognition, and sweating, where dapsone dosage, not just the treatment length, positively affected outcomes. High dose pulsed dapsone combination therapy may represent a novel therapeutic approach for the treatment of resistant CLD/PTLDS, and should be confirmed in randomized, controlled clinical trials.
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