IV Therapy for Lyme Disease: Benefits, Risks & Cost

In the majority of cases, Lyme disease can be treated with oral antibiotics. What happens when oral antibiotics fail? It has been estimated that around 20% of the patients experience Post Treatment Lyme Disease Syndrome that require intravenous administration of antibiotics. When the bacteria crosses the blood-brain barrier, the nervous system will be affected that can lead to neuroborreliosis. In IV administration, the drug will be delivered to the site of infection through bloodstream that provides faster relief. In this blog, we will explore how IV administration of antibiotics provide hope for Lyme disease patients.

What are the treatment options for Lyme disease? The first line standard of treatment for Lyme disease patients is oral antibiotics (amoxicillin, doxycyclin, cephalosporin). The bacteria can attack the immune system of the host and circulate through the blood stream. Antibiotics can stop the proliferation of bacteria by disrupting the cell wall. Anti-inflammatory agents, like NSAIDs can be prescribed for clinical symptoms, such as musculoskeletal pain. Physical therapy can help in restoring the functions of joints and muscles. Dietary and lifestyle modifications can help in reducing the inflammation and support the immune system of the body.

Is IV infusion the most effective solution for patients with chronic Lyme disease symptoms? Intravenous (IV) infusion therapy has become a potentially viable method in treating the clinical symptoms of Lyme disease, especially when oral medications have become ineffective. IV infusion for Lyme disease involves direct administration of antibiotics into the blood circulation that guarantees faster absorption into the body. IV infusion can help patients with neuroborreliosis, Lyme carditis, Lyme arthritis, etc. Other patients say that they experience much greater relief of symptoms such as brain fog, pain in the joints, fatigue, etc. Most of the patients continue to experience clinical symptoms due to Post-Treatment Lyme Disease Syndrome (PTLDS) that results in dysregulation of the immune system.

What are the pros and cons of IV infusion therapy? Pros: When compared to oral antibiotics, IV antibiotics are stronger that kills the bacteria effectively.

Sometimes, oral antibiotics can cause gastrointestinal problems. IV antibiotics will not affect the gastrointestinal system as they have a direct route.

IV antibiotics can help in eliminating persistent forms of bacteria

IV infusion is associated with higher bioavailability and achieves higher concentrations.

Cons: A PICC line delivers a higher dose of antibiotics that kills the bacteria. Your body may not be able to eliminate the dead spirochetes, which can result in Herxheimer reactions.

There is an increased risk of the development of gallstones with IV infusion.

There is a higher risk of blood clot formation or thrombosis

What is the cost of IV infusion of antibiotics? IV infusions for Lyme disease are expensive when compared to oral antibiotics. Patients with Lyme disease face both emotional and financial considerations. If the condition is detected at an early stage, effective treatment can be initiated. Studies have estimated that Lyme disease costs between $712 million and $1.3 billion a year in the US. Another problem is that the insurance will not cover the antibiotic treatment long-term. Intravenous (IV) infusion of antibiotics can be expensive and depends on several factors, such as, Type of drug

Duration of treatment

Facility charges

Location (Whether it is administered at home or in a clinic)

When the treatment is done at home, the expenses are less. The patient has to meet the cost of home infusion equipment and specialized nursing procedures. Hospital-based IV therapy is usually costlier with increased facility fees and administrative costs. Insurance coverage of IV therapy can vary. Patients are advised to discuss treatment regimens, approximate duration, and insurance coverage with their caregiver and insurance provider before entering an IV therapy. Trying out financial aid programs or other interventions can also help the patients.

What is the difference between oral and intravenous administration of antibiotics?

Oral	Intravenous
Antibiotics are administered through the mouth in the form of tablets or capsules	Antibiotics are administered intravenously through a PICC line
The onset of action is slower and depends on the gastrointestinal absorption	Antibiotics are administered directly into the bloodstream, which leads to faster absorption.
The drug concentration is lower when compared to IV infusion	The drug concentration is higher
Oral route is indicated in early or moderate cases of Lyme disease.	IV infusion is indicated in later stages of Lyme disease
Medicines can be self-administered	IV infusion requires hospital or home stay with nursing support
Less cost	Higher cost
Convenient and a conservative approach	Less convenient and an invasive approach
Associated with gastrointestinal upset or allergic reactions	Associated with the blood clots or gallstones
Covered by most of the insurance plans	Insurance is often limited in the case of IV infusion, particularly in chronic cases

References: Global Lyme Alliance. Intravenous antibiotics for Lyme: pros, cons and the lived experience [Internet]. 2020 Oct 15 [cited 2025 Jul 3]. Available from: https://www.globallymealliance.org/blog/intravenous-antibiotics-for-lyme-pros-cons-and-the-lived-experience

Johns Hopkins Lyme Disease Research Center. Lyme Disease Treatment and Prognosis [Internet]. [cited 2025 Jul 3]. Available from: https://www.hopkinslyme.org/lyme-disease/treatment-and-prognosis-of-lyme-disease/

Global Lyme Alliance. The True Cost of Lyme Treatment [Internet]. 2023 [cited 2025 Jul 3]. Available from: https://www.globallymealliance.org/blog/cost-of-treatment

IV Therapy for Lyme Disease: Is the Cost of Infusion the Price of Relief You've Been Hoping For?