• Sebastian Rauer, Stefan Kastenbauer, Volker Fingerle, Klaus-Peter Hunfeld, Hans-Iko Huppertz, and Rick Dersch.
• Department of Neurology and Neurophysiology, Medical Center-University of Freiburg; Neurologische Praxis, München; National Reference Centre for Borrelia, Bavarian Health and Food Safety Authority, Oberschleissheim; Institute for Laboratory Medicine, Microbiology and Hospital Hygiene, Krankenhaus Nordwest, Frankfurt/Main; Klinikum Bremen Mitte, Prof.-Hess-Kinderklinik and Clinic for Pediatric Intensive Care, Bremen; Evidence in Medicine / Cochrane Germany, Medical Center, Faculty of Medicine, University of Freiburg; *All of the editors, authors, and processors of the German S3 guideline on Lyme neuroborreliosis are listed in the eBox.
• Dtsch Arztebl Int. 2018 Nov 9; 115 (45): 751756751-756.

BackgroundThe new German S3 guideline on Lyme neuroborreliosis is intended to provide physicians with scientifically based information and recommendations on the diagnosis and treatment of this disease.MethodsThe scientific literature was systematically searched and the retrieved publications were assessed at the German Cochrane Center (Deutsches Cochrane Zentrum) in Freiburg in the 12 months beginning in March 2014. In addition to the main search terms "Lyme disease," "neuroborreliosis," "Borrelia," and "Bannwarth," 28 further terms relating to neurological manifestations of the disease were used for the search in the Medline and Embase databases and in the Cochrane Central Register of Controlled Trials.ResultsIn the treatment of early Lyme neuroborreliosis, orally administered doxycycline is well tolerated, and its efficacy is equivalent to that of intravenously administered beta-lactam antibiotics (penicillin G, ceftriaxone, and cefotaxime) (relative risk [RR]: 0.98, 95% confidence interval [CI]: [0.68; 1.42], P = 0.93). 14 days of treatment suffice for early Lyme neuroborreliosis, and 14-21 days of treatment usually suffice for late (chronic) Lyme neuroborreliosis.ConclusionLyme neuroborreliosis has a favorable prognosis if treated early. The long-term administration of antibiotics over many weeks or even months for putative chronic Lyme neuroborreliosis with nonspecific symptoms yields no additional benefit and carries the risk of serious adverse effects.

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