Why Lyme treatments often fail

Monica Embers on persistent Lyme.

Close up of a researcher looking through a powerful microscope in a lab doing research, with the CanLyme logo floating on the right hand side.

Monica Embers, PhD, Associate Professor of Microbiology and Immunology at Tulane University, Director of Vector-Borne Disease Research and member of the Tulane National Primate Research Center has been a leading participant in Lyme research. In addition she presents three free CME courses on [IN]VISIBLE for healthcare professionals. Her research program regarding Borrelia burgdorferi and Lyme disease is designed around three central themes:

  1. antibiotic efficacy against Lyme disease;
  2. novel therapeutic strategies to eradicate the infection; and
  3. immunodiagnosis for B. burgdorferi infection and cure.

There is broad agreement that 10-30% of patients treated for early Lyme disease will be left with persistent symptoms, sometimes lasting months or even years. Of those who are diagnosed later, even more will suffer persistent symptoms. There are several potential mechanisms for persistence. These include delayed treatment, persistent infection, co-infections, re-activated infections, genetics, autoimmunity and physical damage to the body caused by the infection. Regardless of the cause, these chronic symptoms share a common element—antibiotic treatment failure when the standard treatment protocols are used. 

A recent review article by Dr. Embers and Heather Adkinson takes a deep dive into three notable mechanisms of treatment failure. It’s entitled Lyme disease and the pursuit of a clinical cure, published in Frontiers in Medicine. The three factors they examine are:

  1. autoimmunity,
  2. post-infectious immune-mediated sequelae [aftereffects], and
  3. persistent infection.


Adkison H, Embers ME. Lyme disease and the pursuit of a clinical cure. Front Med. 2023 May 24;10:1183344:  https://doi.org/10.3389/fmed.2023.1183344

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