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The following is a summary of “Towards shortening the duration of antibiotic therapy for Lyme borreliosis: a systematic review and meta-analysis,” published in the April 2025 issue of Infection by Raffetin et al. 

Researchers conducted a retrospective study to assess the efficacy of shortening antibiotic therapy for patients with Lyme borreliosis (LB) through a systematic review and meta-analysis.  

They searched Medline, Google, and Google Scholar (January 2022–February 2024) following PRISMA and the Cochrane Handbook. Eligible studies included randomized clinical trials (RCTs) and comparative studies with defined LB, antibiotic duration, outcomes, and follow-up of ≥6–12 months. The meta-analysis focused on treatment failure, residual symptoms, and adverse events (AEs). Interventions compared short vs extended antibiotic therapy for erythema migrans (≤10 days vs >10 days) and disseminated LB (≤21 days vs >21 days). The risk of bias was estimated independently using Cochrane Tools. Treatment effects were estimated with a fixed-effect model (Mantel–Haenszel or Peto method) using odds ratios (OR) and 95% CIs.  

The results showed that 38 full-text articles involving 850 individuals were reviewed, with 29 studies included in the qualitative analysis and 6 in the meta-analysis. Heterogeneity was low (I² = 0%). At 12 months, short-term and long-term antibiotic therapies showed no significant difference in treatment failures (OR 1.50, 95%CI [0.43–5.22]) or residual symptoms (OR 0.95, 95% CI [0.66–1.37]), though sample sizes were small.  

Investigators concluded that while this meta-analysis lacked the statistical power to confirm the non-inferiority of shorter treatment durations, it indicated potential safety for uncomplicated early Lyme disease.   

Source: link.springer.com/article/10.1007/s15010-025-02501-3