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Objectives <p>Systematic review and meta-analysis on shortening antibiotic therapy for Lyme borreliosis (LB) patients.</p> Methods <p><i>Data sources:</i> Medline, Google, and Google Scholar (queried from January 2022-February 2024), following the PRISMA method and the Cochrane Handbook.</p> <p><i>Eligibility criteria:</i> Randomized clinical trials, comparative studies; clear definitions of LB, duration of antibiotics and outcome; follow-up ≥ 6–12&#xa0;months. Meta-analysis included studies that examined three outcomes: treatment failure; residual symptoms; adverse events.</p> <p><i>Intervention:</i> Short vs. extended antibiotic therapy for erythema migrans (≤ 10&#xa0;days vs. &gt; 10&#xa0;days) and disseminated LB (≤ 21&#xa0;days vs. &gt; 21&#xa0;days).</p> <p><i>Assessment of risk of bias.</i> Independently, using the Cochrane Tools.</p> Methods <p><i>of data synthesis.</i> Estimation of treatment effects based on a fixed-effect model (Mantel–Haenszel or Peto method), with odds ratio (OR) and 95% confidence intervals (CI).</p> Results <p>Thirty-eight full-text articles were examined (850 patients): 29 were included in the qualitative analysis; six in the meta-analysis. Heterogeneity was low (I<sup>2</sup> = 0%). At 12&#xa0;months, short-term treatment did not differ from long-term treatment in terms of failures (OR1.50, 95%CI[0.43–5.22]) and residual symptoms (OR0.95, 95%CI[0.66–1.37]), albeit with small samples.</p> Conclusion <p>This meta-analysis was underpowered to prove non-inferiority of shorter treatment, but suggests its safety for EM. Studies focusing on antibiotics duration, with sufficient sample sizes and clear outcomes, are warranted.</p> Graphical Abstract <p></p>

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Towards shortening the duration of antibiotic therapy for Lyme borreliosis: a systematic review and meta-analysis

  • 期刊论文

  • 发表日期：

    2025年4月17日

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  • Alice Raffetin,
  • Anna J. Henningsson,
  • Katharina Ornstein,
  • Pauline Arias,
  • Volker Fingerle,
  • Solene Patrat-Delon,
  • Daniel Bremell,
  • Per Eric Lindgren,
  • Tobias A. Rupprecht,
  • Benoît Jaulhac,
  • Klaus-Peter Hunfeld,
  • Céline Cazorla,
  • Mateusz Markowicz,
  • Reto Lienhard,
  • Alje P. van Dam,
  • Elisabeth Baux,
  • Sally Mavin,
  • Joppe W. Hovius,
  • M. E. Baarsma,
  • Kristine Karlsrud Berg,
  • Randi Eikeland,
  • Ram B. Dessau

摘要

Objectives

Systematic review and meta-analysis on shortening antibiotic therapy for Lyme borreliosis (LB) patients.

Methods

Data sources: Medline, Google, and Google Scholar (queried from January 2022-February 2024), following the PRISMA method and the Cochrane Handbook.

Eligibility criteria: Randomized clinical trials, comparative studies; clear definitions of LB, duration of antibiotics and outcome; follow-up ≥ 6–12 months. Meta-analysis included studies that examined three outcomes: treatment failure; residual symptoms; adverse events.

Intervention: Short vs. extended antibiotic therapy for erythema migrans (≤ 10 days vs. > 10 days) and disseminated LB (≤ 21 days vs. > 21 days).

Assessment of risk of bias. Independently, using the Cochrane Tools.

Methods

of data synthesis. Estimation of treatment effects based on a fixed-effect model (Mantel–Haenszel or Peto method), with odds ratio (OR) and 95% confidence intervals (CI).

Results

Thirty-eight full-text articles were examined (850 patients): 29 were included in the qualitative analysis; six in the meta-analysis. Heterogeneity was low (I2 = 0%). At 12 months, short-term treatment did not differ from long-term treatment in terms of failures (OR1.50, 95%CI[0.43–5.22]) and residual symptoms (OR0.95, 95%CI[0.66–1.37]), albeit with small samples.

Conclusion

This meta-analysis was underpowered to prove non-inferiority of shorter treatment, but suggests its safety for EM. Studies focusing on antibiotics duration, with sufficient sample sizes and clear outcomes, are warranted.

Graphical Abstract