Can a Long-Forgotten Antibiotic Be Repurposed Against Lyme Disease?

Lyme disease is increasing in the U.S. due to expansion of vector habitat, human encroachment in previously uninhabited areas, and longer seasonal outdoor activity. Therefore, selective drugs against the causative agent, Borreliella burgdorferi, that would avoid excess risk for microbiome disruption and antimicrobial resistance are highly desirable.

During a screen of soil microorganisms, Leimer et al found a molecule with specific activity against spirochetes (including B. burgdorferi), which turned out to be hygromycin A, a known product of Streptomyces hygroscopicus. Hygromycin A contains a modified cinnamic acid flanked by a furanose sugar and aminocyclitol (and should not be confused with hygromycin B, an unrelated aminoglycoside). Hygr…