Background: A longer duration treatment is preferred in erythema migrans (EM) to prevent late complaints. Objectives: To determine whether 20 (20d-pt) or 14 days (14d-pt) of phenoxymethylpenicillin (PenV) have similar efficacy in treating EM and preventing further sequelae. Patients and Methods: In a prospective double-centre study, 102 patients with EM were treated with PenV 1.5 million IU thrice daily for either 20 or 14 days and followed up for 12 months. Results: The primary cure rate after treatment with PenV was 91.5% (79.6–97.6) for 20d-pt vs. 91.7% (77.5–98.2) for 14d-pt; p > 0.99). In 7 patients (4/20d-pt and 3/14d-pt), persistent or newly arising symptoms required retreatment. After 1 year, all patients were cured. The immune response showed no statistical difference between the treatment groups in the follow-up period. Conclusion: A 2-week treatment regimen of PenV seems to be as effective as a 3-week course with no statistical differences for clinical and serological findings after treatment.
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