Researchers at Alfred I duPont Hospital for Children, Wilmington, DE, and other Centers in Lyme endemic areas determined the frequency and type of all treatment complications at return visits within 30 days of an initial Lyme meningitis diagnosis. Of 149 children, median age of 10 years, with available follow-up records, 39 (26%) had 1 or more complications, and 21 (14%) required a change in antibiotic therapy. Ten percent had an adverse drug reaction. Of 144 with a peripherally inserted central catheter (PICC), 25 (17%) had at least 1 associated complication. [1]

COMMENT. Outpatient treatment with parenteral ceftriaxone (or penicillin) for 14-28 days is recommended for Lyme meningitis [2]. Given the high risk of complications with PICC, Thompson and associates recommend trials of alternate treatment regimens, including oral doxycycline.