DAVID FOLK THOMAS: Brent, how long is this first treatment, these antibiotics, prescribed for?
BRENT WISE, MD: As Alex said, from 14 to 21 days with either doxycycline or amoxicillin. Sometimes an antibiotic called Cefuroxime is employed, as well.
DAVID FOLK THOMAS: How much of the time will this take care of it?
BRENT WISE, MD: This takes care of the vast majority of early cases. If, unfortunately, it has not been caught early and there are more late manifestations of the illness, we sometimes have to do longer courses of antibiotics and sometimes use intravenous antibiotics straight into the bloodstream.
DAVID FOLK THOMAS: Alex, what are some of those later manifestations Brent was alluding to?
ALEX McMEEKING, MD: Possibly arthritis that doesn't respond to oral therapies, neurologic Lyme disease -- sometimes people can get manifestations in the central nervous system of Lyme disease, and sometimes people can get heart involvement with conduction abnormalities and heart arrhythmias. Also, occasionally -- thank goodness, it hasn't happened too often -- but I've had a couple of people who have gotten Lyme disease during pregnancy. Again, they usually recommend using intravenous antibiotics in that situation.
DAVID FOLK THOMAS: As far as if you have some of these later stage developments -- nervous system involvement, et cetera -- then these antibiotics, what do you do beyond them?