Rayban has to prove himself superior – and he was actually proved wrong on lyme anyway as NICE has updated its guidence in the light of new data.
They added an extra round of 28 days of antibiotics for people who still showed symptoms.
However, low and behold – there’s still loads of people complaining all over the web that they’ve still got it and want it for even longer.
Besides that – the decision to give the option for four week and second rounds appears to be based on risk management as opposed to clear evidence that it works.
The committee considered evidence from the PLEASE trial to be particularly relevant when
developing clinical recommendations for people with ongoing symptoms related to Lyme
disease. In the study, all participants received open-label intravenous ceftriaxone for 2 weeks
followed by their randomly assigned study drug; 12 weeks of oral doxycycline, 12 weeks of
oral clarithromycin, or 12 weeks of oral placebo. Although the PLEASE trial showed a quality
of life improvement in all treatment arms, there was no difference between treatment arms.
The committee considered that any quality of life improvements could be due to the initial 2-
Lyme disease: management of ongoing symptoms
Management (ongoing symptoms)
© NICE 2018. All rights reserved. Subject to Notice of rights.
27
week treatment of intravenous ceftriaxone with no clear additional benefit from long-term
treatment with oral doxycycline or clarithromycin. To determine the effectiveness of long-term
antibiotic treatment, study participants should have also been blinded to the intravenous
ceftriaxone treatment, and a fourth treatment arm consisting of only placebo should have
been introduced. The committee considered that the evidence did not provide support for
long-term antibiotic treatment.