IHOMUUTOKSEN HOITO ANTIBIOOTEILLA

[Bb]

Lähettäjä: Soijuv Lähetetty: 24.1.2006 10:35

Azithromysiini ja fenoksimetyylipenisilliini osoittautuivat itävaltalaisessa tutkimuksessa yhtä tehokkaiksi lasten yksittäisen erytheeman hoidossa. Kummallakin esiintyi myös saman verran sivuvaikutuksia. Lapsia seurattiin vuoden ajan.

(Suom. huom. Varhaisvaiheen borrelioosissa ilmenevä ihomuutos häviää ajan myötä lähes poikkeuksetta itsestään ilman antibioottejakin. Borreliabakteeri sen sijaan ei ole hävinnyt elimistöstä vaan kadonnut syvemmälle kudoksiin eri puolille elimistöä. Lasten terveydentilaa tulisi seurata vuosien jopa vuosikymmenten ajan, jotta saataisiin luotettavampaa tietoa hoidon tehosta.)


Solitary erythema migrans in children: comparison of treatment with
azithromycin and phenoxymethylpenicillin.
Wien Klin Wochenschr. 2002 Jul 31;114(13-14):498-504.
Arnez M, Pleterski-Rigler D, Luznik-Bufon T, Ruzic-Sabljic E, Strle F.

Department of Infectious Diseases, University Medical Centre, Ljubljana,
Slovenia. maja.arnez@kclj.si

OBJECTIVE: To compare clinical effectiveness and side effects of treatment
with azithromycin or phenoxymethylpenicillin in children with solitary
erythema migrans.

METHODS: Consecutive patients younger than 15 years,
referred to our institution in 1998 and 1999 with previously untreated
typical solitary erythema migrans, were included in this prospective study.
Basic demographic features and clinical data were collected by means of a
questionnaire. The efficiency of treatment of acute disease, development of
later major and/or minor manifestations of Lyme borreliosis and side effects
of treatment were surveyed by follow-up visits during the first year.

RESULTS: Forty-two patients received azithromycin 20 mg/kg/day for the first
day followed by 10 mg/kg/day for a further four days and
phenoxymethylpenicillin 100,000 IU/kg/day for 14 days. No differences in
demographic and clinical pre-treatment characteristics were present in the
two groups, with the exception of the duration of erythema migrans before
treatment (3 days in the azithromycin group versus 4 days in the
phenoxymethylpenicillin group; p = 0.0320). The clinical course during the
post-treatment period revealed no significant differences between the two
groups in the duration of EM (3 days versus 4 days; p = 0.2471), the
appearance of minor manifestations of Lyme borreliosis (17.5% in the
azithromycin group versus 24.4% in the phenoxymethyl-penicillin group; p =
0.6252), or in the emergence of major manifestations of Lyme borreliosis
(one patient in each treatment group). One year after antibiotic treatment
all patients were asymptomatic. Side effects of treatment were observed in
5.3% of patients treated with azithromycin and in 6% treated with
phenoxymethylpenicillin. The appearance of "Herxheimer's reaction" at the
beginning of treatment was recorded in 7 out of 42 patients (6%) in each
treatment group.

CONCLUSIONS: Azithromycin and phenoxymethylpenicillin are
equally effective in treatment of children with solitary erythema migrans
and have comparable side effects.

Publication Types:
Clinical Trial
Randomized Controlled Trial

PMID: 12422590 [PubMed - indexed for MEDLINE]