Pneumonia Antibiotic Cures Lyme Disease at Doses 100 Times Lower Than Standard Treatment
A pre-clinical study shows the antibiotic, piperacillin, was effective at much lower dosages than doxycycline, and did so without disrupting the gut microbiome.
A pre-clinical study demonstrated that piperacillin, an FDA-approved antibiotic, that inhibits peptidoglycan production, could be a more effective treatment for Lyme disease than doxycycline, the current standard treatment.1
This could be a potentially promising development since doxycycline is not effective in up to 20% of patients.1
“Piperacillin may be a game-changer for improving Lyme disease treatment, which is currently a challenge for researchers and physicians. Furthermore, our new mechanistic understanding of how piperacillin affects peptidoglycan synthesis is unexpectedly informing our development of a biomarker-based approach to diagnose acute Lyme disease,” Brandon Jutras, PhD, associate professor of Microbiology-Immunology at Northwestern University Feinberg School of Medicine, said in a statement.1
For this study, Investigators screened nearly 500 FDA-approved compounds to identify potential treatments for Lyme disease. Piperacillin stood out in laboratory studies with mice, effectively killing the Lyme-causing bacterium, Borrelia burgdorferi, at very low concentrations by targeting its unique peptidoglycan cell-wall pattern. Piperacillin cured infection at doses 100 times lower than doxycycline.
A second study demonstrated how lingering peptidoglycan builds up in the joint fluid and liver, contributing to chronic Lyme symptoms. The study focused on the bacterium that causes Lyme disease, and its unique cell wall component called peptidoglycan. This molecule was found to persist in joint fluids in human samples, potentially driving inflammation and long-term health issues. Using pre-clinical models, the team discovered that the liver acts as a “storage site” for bacterial peptidoglycan, where it can remain for weeks or months, unlike peptidoglycan produced by other bacteria. The presence of peptidoglycan triggered changes in immune responses and energy metabolism like fatigue and inflammation. These findings suggest that lingering bacterial molecules like peptidoglycan could play a role in chronic Lyme disease, drawing parallels to other chronic conditions like Long COVID, where persistent antigens may contribute to ongoing heath issues.
“Our second study explores the role of peptidoglycan in chronic Lyme symptoms; peptidoglycan influences an inflammatory and chronic illness response for weeks or even months after infection, adding to the growing evidence that remnants of bacteria and viruses can stick around and keep affecting the body, similar to the occurrence of Long COVID in some patients,” Jutras said,
The results of both studies were published in the journal, Science Translational Medicine.
Piperacillin: An Older, Generic Antibiotic, With a Significant Role
Piperacillin is a treatment that has been approved for many years and it is used primarily in combination with the beta lactamase inhibitor tazobactam for severe healthcare-associated infections (HAI).2 For example, piperacillin-tazobactam is recommended as part of a 3-drug regimen for the treatment of hospital-acquired pneumonia. The combination therapy is also recommended as initial empiric treatment for people with suspected neutropenic sepsis.2 The FDA approved the combination therapy in 1993, and it is administered intravenously.3
Lyme Disease’s Impact
According to the Centers for Disease Control and Prevention (CDC), over 89,000 cases of Lyme disease were reported by state health departments and the District of Columbia in 2023. However, CDC notes on its site this is just 1 way public health tracks cases and other recent estimates using other methods suggest that approximately 476,000 people are diagnosed with the disease each year in the US. 4 This vector-borne disease is transmitted by blacklegged (Ixodes) ticks to people.5
If left untreated, Lyme disease can produce a number of symptoms including fever, rash, facial paralysis, an irregular heartbeat, and arthritis, depending on the stage of infection.
Post-Treatment Lyme Disease Syndrome
For some people treated for Lyme disease they may have prolonged symptoms, and it is officially known as, Post-Treatment Lyme Disease Syndrome (PTLDS). This can cause people to have fatigue, body aches, or difficulty thinking months after antibiotic treatment.6
CDC does caution people that these symptoms can come from other infections, medications, depression, diabetes, and cancer. And the federal agency writes on its site that it is unlikely that Lyme disease is the cause of prolonged or recurring symptoms if the individual has tested negative for Lyme disease using a recommended test or have not lived in or traveled to areas where the disease is common.6
