I have numerous problems with this paper – including the utilization of the PTLDS moniker and the faulty 10-20% that go on to suffer with persistent symptoms, as both are misleading and have dire consequences.
While they state persister bacteria have been documented after antibiotics in vitro, they state work in humans is inconclusive, when reality has shown a far different picture as well as the fact viable spirochetes have been found in these patients.
They state that much more work remains yet due to them downplaying the problem with faulty, low percentages – that work will never happen. This tactic has been used for over 40 years.
It continues to amuse me that while they insist upon direct isolation of persisters in well-controlled animal experiments, the COVID-19 debacle continues to date without having this! Once again this proves the double standard regarding Lyme/MSIDS.
And very sadly, they state that “clinical evidence does not support its efficacy” regarding prolonged treatment. Your’s truly would not be writing this post today without this very maligned way of treating. They also state that there is no sustained benefit in reducing chronic symptoms after initial treatment – yet here I am defying that very statement, and I’m far from alone.
Please understand, I’m not advocating a willy-nilly, indiscriminate treatment regimen. Treating this is probably one of the most difficult things to treat. For an example of what effective treatment looks like go here.