Prolonged cefazolin course for treatment of methicillin susceptible staphylococcus species infections and the impact on the emergence of multidrug-resistant bacteria during cloxacillin shortage

Objectives: Overdiagnosis of lyme borreliosis leads to unnecessary and increasingly common antimicrobial treatments. We aimed to evaluate patients receiving long-term antimicrobial treatment for lyme borreliosis. Methods: We included patients referred to a Parisian teaching hospital between January 1st, 2014 and June 30th, 2019, with a presumed diagnosis of lyme borreliosis for which they were treated with antimicrobials for at least 6 months. Results: Fifteen patients were included (11 women and mean age 44 years). The mean antimicrobial treatment duration was 476 days (180-942). The mean number of antimicrobials was 6.8 per patient (1-18). None of the 15 patients had lyme borreliosis. Nine patients were diagnosed with a mental disorder. Conclusion: Overdiagnosis and overtreatment of lyme borreliosis put patients at risk of undiagnosed illnesses and multiple adverse effects of unjustified treatments. The clinical management of such patients requires a comprehensive approach including expertise in mental disorders.