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Treatment options
Treating coinfections

Monitoring for successful treatment

Treatment of Lyme disease is not short. A minimal treatment period of ceftriaxone for mild Lyme would be at least 3 months. Minimal treatment with orals will be many many months even for mild Lyme

Firstly 

Your patient should run a diary. I get my patients to run one along the same lines as a 10 point pain diary, and each morning to rate how they felt the previous day. This will help to give a guide to what is working and what is not.

Secondly the CD57 test 

Critical update Dec 2nd 2010 see CD57 Test page

The CD57 lymphocyte is currently the only laboratory indicator of success in treating Lyme disease. It is done by flow cytometry and can be ordered at limited laboratories here in Australia as part of a LSM request. Contact author for information on where.

Refer to the page CD57 Test for detailed information on CD57+ NK cells

As treatment progresses, if successful,  the count will rise. There are as yet no accepted standards of a count that signifies successful treatment but I am sure we will see that soon. Critical update on this topic. Here is a study that shows some interesting figures on the rising CD57 value with treatment http://www.ncbi.nlm.nih.gov/pubmed/11222912

Thirdly how long is treatment?

Months

and for some patients it may be 1-2 years including intravenous therapy. Liken it to the treatment time of TB.

At the end of treatment the patient in theory should have an IgG western blot that is positive