This time regarding the use of "long-term" antibiotics in chronic Lyme...although I would not consider 12 weeks to be long term myself.
In this randomized, double-blind trial involving patients with persistent symptoms attributed to Lyme disease, prolonged antibiotic treatment (ceftriaxone followed by 12 weeks of either doxycycline or clarithromycin–hydroxychloroquine) did not lead to a better health-related quality of life than that with shorter-term treatment (ceftriaxone followed by placebo).
Get ready for the media to jump on the "long term antibiotics don't work" bandwagon...and almost certainly insurance companies too.The current trial has several limitations. First, patients received open-label antibiotics for 2 weeks before the randomized phase. Consequently, the study was designed to compare longer-term therapy with shorter-term therapy, rather than with placebo as was done in previous trials.4,5,18Although we did not identify any benefit of longer-term therapy, the question of whether a 2-week regimen of antibiotics is superior to withholding any therapy in our patient population remains unanswered. We chose not to include a study group that received only placebo because it was judged to be unethical to withhold treatment from patients who might have an infection at baseline that had not yet been treated. We selected ceftriaxone because it is considered the treatment of choice for disseminated Lyme disease.5,8 Thus, although 14 weeks of antimicrobial therapy did not provide a clinical benefit for patients with persistent symptoms attributed to Lyme disease, our results cannot show whether our study may have included patients with undiagnosed active B. burgdorferi infection, who have benefited from ceftriaxone treatment.