I am including some quotes from Dr. J.J. Burrascano, Jr., M.D., one of the leading authorities on Lyme-disease. The following quotes were taken from Managing Lyme Disease -- Diagnostic Hints and Treatment Guidelines for Lyme Borreliosis. This booklet is "the bible" for every doctor and patient dealing with Lyme disease. This booklet, along with other information, has previously been provided to MRG.
"Treatment remains difficult. It is impossible to know how much medication will be necessary to control the infection, because response to therapy is mostly subjective. Also, it cannot be determined which of the many complaints will improve with further antibiotics, and which are permanent. There is no test available that relates to how effective the treatment regimen is, and there is no test for cure."
"Because the Lyme spirochete is rapidly distributed to all parts of the body, including the Central Nervous System once it enters the bloodstream, the antibiotic chosen must be able to penetrate all tissues in adequate concentrations to be bacteriocidal to the organism..."
"There are four types of antibiotics in general use for Lyme treatment. The tetracyclines, including doxycycline and minocycline, are bacteriostatic at doses commonly prescribed, and treatment failures in early and late disease are becoming more apparent. Tetracycline itself does not penetrate into the Central Nervous System as well as doxycycline and minocycline and its use is not advised in any case. Doxycycline can be very effective only if high blood levels are achieved either by high oral doses (300 to 600 mg daily) or by parenteral administration." (Parenteral therapy is intramuscular or intravenous antibiotic therapy and is used for more ill patients and those unresponsive to or intolerant of oral medication.)
"The concept of a "therapeutic alliance" between the caregiver and patient means that the patient must take responsibility for complying with the recommendations give, maintaining the best possible health status, reporting promptly any problems or new symptoms, and especially in realizing that despite all our best efforts, success in diagnosis and treatment is never assured."
"I have found conclusively that the duration of treatment is just as important as the choice of antibiotic. If treatment is discontinued before all symptoms of active infection have cleared, the patient will remain ill and possibly relapse further. All patients respond differently and therapy must be individualized."
"In addition, repeated treatment failures should alert the clinician to the possible existence of an otherwise not apparent immune deficiency, and a workup for this then may be advised."
"Clinically, it has been observed that cycles of symptoms will occur every four weeks. If the antibiotics are working, over time these flares will lessen in severity and duration. The very occurrence of ongoing monthly cycles indicates that living organisms are still present and that antibiotics should be continued."
"With more careful dosing and more prolonged treatment durations, chronic symptoms can be eliminated or prevented."
"In late stage disease, many negative effects to the body are occurring: the muscles are atrophying, and to some degree, the heart muscle also suffers, as do the joints, tendons, nerves, etc."
"Lyme disease patients are stiff, weak, tired, have poor stamina, and are at increased risk for cardiovascular disease and diabetes. Antibiotic treatment alone cannot correct these effects. Therefore, it is necessary to include various forms of physical and exercise therapy, the extent of which depends on an individual patient's condition."
"...may have periods of dormancy, during which time antibiotics will not kill the organism, treatment may have to be continued for a long period of time to eradicate all the active symptoms and to prevent a relapse, especially in late infections."