Treatment recommendations vary with the stage of disease. Most manifestations of Lyme disease can be treated with oral doxycycline or oral amoxicillin, which will usually cure the patient. In fact doxycycline for adults and amoxicillin for children are the most popular treatments and usually prevent the infection (Bhate et al. 2011b). Patients such as those with neurologic abnormalities or Lyme arthritis may require intravenous ceftriaxone (Alao et al. 2012). Doxycycline is a tetracycline antibiotic that is lipophilic and can pass through the lipid bilayer of bacteria. It reversibly binds to the 30 S ribosomal subunits, blocking the binding of aminoacyl tRNA to the mRNA and inhibiting bacterial protein synthesis (Drug Bank). Amoxicillin binds to penicillin-binding protein 1 located inside the bacterial cell wall and prevents the formation of a cross-link of two linear peptidoglycan stands and causes cell lysis (Drug Bank). Ceftriaxone is a cephalosporin antibiotic that inhibits the mucopeptide synthesis in the bacterial cell wall, which results in the formation of defective cell walls and cell death (Drug Bank).
There has been an effort to produce a possible vaccine for Lyme disease however finding a plausible target has been difficult. There used to be a vaccine that targeted the outer surface lipoprotein A, however, it was withdrawn from the market a decade ago due to serious side effects (Bhattacharjee 2013). With the rapid spread of Lyme disease, a vaccination would be very useful and the scientific community should continue looking for possible vaccination targets.