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Lyme Disease Treatment Fails With Common Antibiotics That Only Kill The Active Form

Borrelia afzelii and Borrelia garinii are the leading causes of Lyme borreliosis (LB) in Europe. Persistent LB forms may involve biofilms, potentially contributing to antibiotic tolerance.

Methods:

Whole-genome sequencing was conducted on 7 B. afzelii and 5 B. garinii isolates from erythema migrans skin biopsies.

Biofilms were analyzed for extracellular DNA (eDNA) content…

[They looked at the effect of amoxicillin, azithromycin, ceftriaxone, and doxycycline].

B. afzelii and B. garinii significantly reduce antibiotic efficacy, particularly ceftriaxone and doxycycline. These in vitro findings highlight the need for targeted therapeutic strategies and suggest biofilms may impact treatment outcomes in LB. [What? biofilms require 1000x the dose!]


Fabrizio G, Cavallo I, Sivori F, Truglio M, Kovacs D, Francalancia M, D’Agosto G, Trento E, Prignano G, Mastrofrancesco A, Ruzič-Sabljič E, Pimpinelli F, Di Domenico EG. Genomic characterization and antibiotic susceptibility of biofilm-forming Borrelia afzelii and Borrelia garinii from patients with erythema migrans. Front Cell Infect Microbiol. 2025 Jul 7;15:1619660. doi: 10.3389/fcimb.2025.1619660. PMID: 40692686; PMCID: PMC12277364.

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