Evidence map›Paper›PMID 30796143›Full record

Trial reportNeurology2019

Effect of prolonged antibiotic treatment on cognition in patients with Lyme borreliosis.

Anneleen Berende, Hadewych J M Ter Hofstede, Fidel J Vos, Michiel L Vogelaar, Henriët van Middendorp, Andrea W M Evers, Roy P C Kessels, Bart Jan Kullberg

Registry-linked trialOpen access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Neurology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01207739 (Persistent Lyme Empiric Antibiotic Study Europe. A Prospective, Randomised Study Comparing Two Prolonged Oral Antibiotic Strategies After Initial Intravenous Ceftriaxone Therapy for Patients With Symptoms of Proven or Possible Persistent Lyme Disease), which is not on this map. Cited by 12 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 1 pooled it
3.4field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01207739 phase4completednot on this map

Persistent Lyme Empiric Antibiotic Study Europe. A Prospective, Randomised Study Comparing Two Prolonged Oral Antibiotic Strategies After Initial Intravenous Ceftriaxone Therapy for Patients With Symptoms of Proven or Possible Persistent Lyme Disease

TypeinterventionalSponsorRadboud University Medical CenterRan2010 to 2014Enrolled280ConditionsLyme Disease, Borrelia InfectionArmsDoxycycline, Clarithromycin and hydroxychloroquine, Placebo
3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 1 synthesis or guideline pooled it, 45 citations in OpenAlex.

  1. Pooled it
  2. Antibiotics for Rheumatologic Diseases: A Critical Review.International journal of molecular sciences · 2025
    Review
  3. Article
  4. Article
  5. Persistent Symptoms After Treatment of Lyme Disease.Infectious disease clinics of North America · 2022
    Review
  6. Article
  7. Article
  8. Review
  9. Article
  10. Article
  11. Observational
  12. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 2 countries.

Anneleen BerendeFrom the Department of Medicine (A.B., H.J.M.t.H., F.J.V., B.J.K.), Radboud Center for Infectious Diseases (A.B., H.J.M.t.H., F.J.V., B.J.K.), and Department of Medical Psychology (M.L.V., H.v.M., A.W.M.E., R.P.C.K.), Radboud University Medical Center; Department of Medicine (F.J.V.), Sint Maartenskliniek, Nijmegen; Institute of Psychology (H.v.M., A.W.M.E.), Health, Medical, and Neuropsychology Unit, Leiden University; and Donders Institute for Brain, Cognition and Behaviour (R.P.C.K.), Radboud University, Nijmegen, the Netherlands. Anneleen.Berende@radboudumc.nl.
Hadewych J M Ter HofstedeFrom the Department of Medicine (A.B., H.J.M.t.H., F.J.V., B.J.K.), Radboud Center for Infectious Diseases (A.B., H.J.M.t.H., F.J.V., B.J.K.), and Department of Medical Psychology (M.L.V., H.v.M., A.W.M.E., R.P.C.K.), Radboud University Medical Center; Department of Medicine (F.J.V.), Sint Maartenskliniek, Nijmegen; Institute of Psychology (H.v.M., A.W.M.E.), Health, Medical, and Neuropsychology Unit, Leiden University; and Donders Institute for Brain, Cognition and Behaviour (R.P.C.K.), Radboud University, Nijmegen, the Netherlands.
Fidel J VosFrom the Department of Medicine (A.B., H.J.M.t.H., F.J.V., B.J.K.), Radboud Center for Infectious Diseases (A.B., H.J.M.t.H., F.J.V., B.J.K.), and Department of Medical Psychology (M.L.V., H.v.M., A.W.M.E., R.P.C.K.), Radboud University Medical Center; Department of Medicine (F.J.V.), Sint Maartenskliniek, Nijmegen; Institute of Psychology (H.v.M., A.W.M.E.), Health, Medical, and Neuropsychology Unit, Leiden University; and Donders Institute for Brain, Cognition and Behaviour (R.P.C.K.), Radboud University, Nijmegen, the Netherlands.
Michiel L VogelaarFrom the Department of Medicine (A.B., H.J.M.t.H., F.J.V., B.J.K.), Radboud Center for Infectious Diseases (A.B., H.J.M.t.H., F.J.V., B.J.K.), and Department of Medical Psychology (M.L.V., H.v.M., A.W.M.E., R.P.C.K.), Radboud University Medical Center; Department of Medicine (F.J.V.), Sint Maartenskliniek, Nijmegen; Institute of Psychology (H.v.M., A.W.M.E.), Health, Medical, and Neuropsychology Unit, Leiden University; and Donders Institute for Brain, Cognition and Behaviour (R.P.C.K.), Radboud University, Nijmegen, the Netherlands.
Henriët van MiddendorpFrom the Department of Medicine (A.B., H.J.M.t.H., F.J.V., B.J.K.), Radboud Center for Infectious Diseases (A.B., H.J.M.t.H., F.J.V., B.J.K.), and Department of Medical Psychology (M.L.V., H.v.M., A.W.M.E., R.P.C.K.), Radboud University Medical Center; Department of Medicine (F.J.V.), Sint Maartenskliniek, Nijmegen; Institute of Psychology (H.v.M., A.W.M.E.), Health, Medical, and Neuropsychology Unit, Leiden University; and Donders Institute for Brain, Cognition and Behaviour (R.P.C.K.), Radboud University, Nijmegen, the Netherlands.
Andrea W M EversFrom the Department of Medicine (A.B., H.J.M.t.H., F.J.V., B.J.K.), Radboud Center for Infectious Diseases (A.B., H.J.M.t.H., F.J.V., B.J.K.), and Department of Medical Psychology (M.L.V., H.v.M., A.W.M.E., R.P.C.K.), Radboud University Medical Center; Department of Medicine (F.J.V.), Sint Maartenskliniek, Nijmegen; Institute of Psychology (H.v.M., A.W.M.E.), Health, Medical, and Neuropsychology Unit, Leiden University; and Donders Institute for Brain, Cognition and Behaviour (R.P.C.K.), Radboud University, Nijmegen, the Netherlands.
Roy P C KesselsFrom the Department of Medicine (A.B., H.J.M.t.H., F.J.V., B.J.K.), Radboud Center for Infectious Diseases (A.B., H.J.M.t.H., F.J.V., B.J.K.), and Department of Medical Psychology (M.L.V., H.v.M., A.W.M.E., R.P.C.K.), Radboud University Medical Center; Department of Medicine (F.J.V.), Sint Maartenskliniek, Nijmegen; Institute of Psychology (H.v.M., A.W.M.E.), Health, Medical, and Neuropsychology Unit, Leiden University; and Donders Institute for Brain, Cognition and Behaviour (R.P.C.K.), Radboud University, Nijmegen, the Netherlands.
Bart Jan KullbergFrom the Department of Medicine (A.B., H.J.M.t.H., F.J.V., B.J.K.), Radboud Center for Infectious Diseases (A.B., H.J.M.t.H., F.J.V., B.J.K.), and Department of Medical Psychology (M.L.V., H.v.M., A.W.M.E., R.P.C.K.), Radboud University Medical Center; Department of Medicine (F.J.V.), Sint Maartenskliniek, Nijmegen; Institute of Psychology (H.v.M., A.W.M.E.), Health, Medical, and Neuropsychology Unit, Leiden University; and Donders Institute for Brain, Cognition and Behaviour (R.P.C.K.), Radboud University, Nijmegen, the Netherlands.
Czech Academy of Sciences, Institute of Psychology · CZLeiden University · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo investigate whether longer-term antibiotic treatment improves cognitive performance in patients with persistent symptoms attributed to Lyme borreliosis.

methodsData were collected during the Persistent Lyme Empiric Antibiotic Study Europe (PLEASE) trial, a randomized, placebo-controlled study. Study participants passed performance-validity testing (measure for detecting suboptimal effort) and had persistent symptoms attributed to Lyme borreliosis. All patients received a 2-week open-label regimen of intravenous ceftriaxone before the 12-week blinded oral regimen (doxycycline, clarithromycin/hydroxychloroquine, or placebo). Cognitive performance was assessed at baseline and after 14, 26, and 40 weeks with neuropsychological tests covering the cognitive domains of episodic memory, attention/working memory, verbal fluency, speed of information processing, and executive function.

resultsBaseline characteristics of patients enrolled (n = 239) were comparable in all treatment groups. After 14 weeks, performance on none of the cognitive domains differed significantly between the treatment arms (

conclusionsA 2-week treatment with ceftriaxone followed by a 12-week regimen of doxycycline or clarithromycin/hydroxychloroquine did not lead to better cognitive performance compared to a 2-week regimen of ceftriaxone in patients with Lyme disease-attributed persistent symptoms. CLINICALTRIALSGOV IDENTIFIER: NCT01207739. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that longer-term antibiotics in patients with borreliosis-attributed persistent symptoms does not increase cognitive performance compared to shorter-term antibiotics.

Indexed as

CognitionAdultAnti-Bacterial AgentsCeftriaxoneChronic DiseaseClarithromycinDouble-Blind MethodDoxycyclineFemaleHumansHydroxychloroquineLyme DiseaseMaleMiddle AgedNeuropsychological TestsAnti-Bacterial AgentsCeftriaxoneClarithromycinDoxycyclineHydroxychloroquine

Identifiers

PMID30796143
PMCPMC6453770
OpenAlexW2917194336

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.