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Early diagnosis and management of Lyme disease are essential to prevent chronic neurologic, cardiac, and joint involvement. This randomized study evaluated the efficacy and safety of three antibiotic regimens in 57 patients with early Lyme disease. Most presented with erythema migrans; two patients without rash had flu-like symptoms and serologic evidence of Borrelia burgdorferi infection.
The patients received either oral azithromycin (500 mg on the first day, followed by 250 mg daily for 4 days); oral amoxicillin (500 mg) on the first day, followed by probenecid (500 mg three times daily for 10 days); or doxycycline (100 mg twice daily for 10 days). Symptoms resolved in 54 of the 57 patients within 3 to 30 days of study entry, with no sign…