Level 2: Mid-level evidence
The efficacy of oral doxycycline was compared with that of IV ceftriaxone (Rocephin) in a randomized trial of 118 patients with Lyme neuroborreliosis (Lancet Neurol. 2008;7:690-695). Patients were randomized to oral doxycycline 200 mg plus IV placebo vs. IV ceftriaxone 2 g plus oral placebo once daily for 14 days. Analysis based on a 64-point clinical neurologic scale included 86% of patients. There were no signifi-cant differences in residual symptoms (59% with doxycycline vs. 52% with ceftriaxone) or side effects at four months.