{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T14:55:18Z","timestamp":1787583318898,"version":"build-2736575974"},"reference-count":28,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T00:00:00Z","timestamp":1694304000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Evidence\u2010based recommendations for treatment of Lyme neuroborreliosis (LNB) should rely on the available literature. As new data emerges, close review and evaluation of the recent literature is needed to build evidence\u2010based recommendations to inform clinical practice and management of LNB. We performed an update of a previous systematic review on treatment of LNB.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic literature search of Medline and CENTRAL was performed for published studies from 2015 to 2023 to update a previous systematic review. Randomized controlled trials (RCTs) and non\u2010randomized studies (NRS) were evaluated. Risk of bias was assessed using the Cochrane risk of bias tools for RCTs; NRS were assessed using the ROBINS\u2010I\u2010tool. Quality of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Data were integrated into an existing meta\u2010analysis of the available literature.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After screening 1530 records, two RCTs and five NRS with new and relevant data were additionally identified. Meta\u2010analysis showed no statistically significant difference between doxycycline and beta\u2010lactam antibiotics regarding residual neurological symptoms after 12\u2009months. Meta\u2010analysis showed no benefit of extended antibiotic treatment of LNB. Three NRS show no benefit for additional steroid use in LNB with facial palsy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Additional incorporated recent research corroborates existing guideline recommendations for treatment of LNB. New RCTs add to the certainty of previous analysis showing similar efficacy for doxycycline and beta\u2010lactam antibiotics in LNB. Available evidence shows no benefit for extended antibiotic treatment in LNB. NRS do not suggest a role for steroids in facial palsy due to LNB.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.16034","type":"journal-article","created":{"date-parts":[[2023,8,11]],"date-time":"2023-08-11T09:02:12Z","timestamp":1691744532000},"page":"3780-3788","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Efficacy and safety of pharmacological treatments for Lyme neuroborreliosis: An updated systematic review"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7366-4401","authenticated-orcid":false,"given":"Rick","family":"Dersch","sequence":"first","affiliation":[{"name":"Clinic of Neurology and Neurophysiology, Medical Center\u2014University of Freiburg, Faculty of Medicine University of Freiburg  Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Rauer","sequence":"additional","affiliation":[{"name":"Clinic of Neurology and Neurophysiology, Medical Center\u2014University of Freiburg, Faculty of Medicine University of Freiburg  Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,9,10]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.12744"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1505425"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2021.05.011"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare8040383"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s004150050214"},{"key":"e_1_2_12_7_1","first-page":"751","article-title":"Lyme Neuroborreliosis","volume":"115","author":"Rauer S","year":"2018","journal-title":"Dtsch \u00c4rztebl Int"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/2046-4053-3-117"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d5928"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4919"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2021.08.022"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.07.015"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2022-329724"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa217"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12887-022-03335-w"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.51488"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciab370"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.14962"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26273"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(08)70119-4"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.44.7.1203"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00328508"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-007-0340-2"},{"issue":"10","key":"e_1_2_12_24_1","first-page":"1568","article-title":"Adverse events associated with antibiotics and intravenous therapies for post\u2010Lyme disease syndrome in a commercially insured sample","volume":"67","author":"Goodlet KJ","year":"2018","journal-title":"Clin Infect Dis"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000011151"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awn116"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2018.03.016"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12887-021-02571-w"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2021.11.001"}],"container-title":["European Journal of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ene.16034","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,27]],"date-time":"2024-02-27T12:06:22Z","timestamp":1709035582000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ene.16034"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,10]]},"references-count":28,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2023,12]]}},"alternative-id":["10.1111\/ene.16034"],"URL":"https:\/\/doi.org\/10.1111\/ene.16034","archive":["Portico"],"relation":{},"ISSN":["1351-5101","1468-1331"],"issn-type":[{"value":"1351-5101","type":"print"},{"value":"1468-1331","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,10]]},"assertion":[{"value":"2023-06-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-03","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}