Efficacy of Double-Dose Dapsone Combination Therapy in the Treatment of Chronic Lyme Disease/Post-Treatment Lyme Disease Syndrome (PTLDS) and Associated Co-infections: A Report of Three Cases and Retrospective Chart Review.
Level 4 - case-series / case-control
Retrospective case series and chart review without a control group
PubMed 33105645 · doi:10.3390/antibiotics9110725
What was done
Three patients with long-standing relapsing Lyme disease and co-infections refractory to prior antibiotics were treated with double-dose dapsone combination therapy (DDD CT) for 7 to 8 weeks. Additionally, a retrospective chart review was conducted on 37 other patients treated with DDD CT, totaling 40 patients.
What was found
In the initial 3 case reports, major Lyme symptoms remained in remission for 25 to 30 months post-treatment. Across the full chart review cohort (n = 40), 98% showed tick-borne symptom improvement, and 45% achieved remission lasting 1 year or longer.
Why it matters
The findings describe a potential treatment protocol for chronic Lyme disease and post-treatment Lyme disease syndrome in patients who have failed conventional antibiotic therapies, generating a hypothesis for future controlled trials.
Limits
The study is an uncontrolled, retrospective chart review with a small sample size (n = 40). Lacking a randomized placebo or standard-care control arm, it cannot rule out placebo effects, natural disease fluctuation, or selection bias. Adverse effects and specific combination drug regimens are not detailed in the abstract.
Cited by
- partial A 9-week dapsone antibiotic protocol induces remission in approximately half of patients with chronic Lyme disease who do not have active Babesia, Bartonella, or mold illness.