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Comment by PragmaticPulp

Note that they're carefully dancing around the elephant in the room: As far as I know, no one has ever demonstrated that Lyme spirochetes survive a course of standard antibiotics (Emphasis mine):

> Standard treatment of Lyme disease is oral antibiotics, typically doxycycline, in the early stages of the disease; but for reasons that are unclear, the antibiotics don't work for up to 20% of people with the tick-borne illness. One possibility is that drug-tolerant bacteria cause the lingering symptoms.

Many people experience lingering symptoms after contracting Lyme disease. Officially, this is known as "Post-Treatment Lyme Disease Syndrome". The CDC page for the PTLDS has more information: https://www.cdc.gov/lyme/postlds/index.html

These PTLDS symptoms are definitely real, but the idea that persistent lyme infection is the cause of the lingering problems is more of a hypothesis at this point.

It will be interesting to see if this new antibiotic produces different outcomes in PTLDS patients, but it's misleading to claim that this is the only antibiotic known to act on the Lyme disease spirochetes. The original study specifically explored the action of Azlocillin on Doxycycline-resistant spirochetes. From the study:

> Our results also demonstrate that azlocillin and cefotaxime can effectively kill in vitro doxycycline-tolerant B. burgdorferi.

The authors point to indirect evidence suggesting that spirochetes might still be present in PTLDS patients, but acknowledge that no one has yet been able to culture a viable spirochete from PTLDS patients:

> A recent study in humans demonstrated that B. burgdorferi DNA was identified in PTDLS patient by xenodiagnosis but unable to culture viable spirochete17. In about 85% of Lyme arthritis patients, B. burgdorferi DNA was detected in synovial fluid by polymerase chain reaction (PCR) testing

It would be great if this antibiotic could produce positive outcomes for PTLDS patients, but I wouldn't get too excited until we see some human studies. PTLDS (aka "chronic lyme") has a long history of promising treatments failing to produce results in patients.

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