Six countries, six protocols

Split between IDSA (short-course) and ILADS (long-term, individualized).

Acute care

Doxycycline 10–21 days (IDSA) or 4–6 weeks (ILADS).

Chronic care

Combination antibiotics (doxy + tinidazole, or rifampin), often 6–18 months under ILADS.

Herbal & integrative

Buhner protocol, Cowden protocol, Byron White formulas widely used by integrative MDs.

Insurance

IDSA protocols covered; long-term ILADS treatment usually self-pay.

NICE guidelines: short course, no recognition of chronic Lyme.

Acute care

Doxycycline 21 days; amoxicillin or azithromycin as alternatives.

Chronic care

Generally not treated on NHS. Patients seek BCA-clinic (DE) or Breakspear (UK private).

Herbal & integrative

Not part of NHS care; private clinics offer Buhner-style protocols.

Insurance

NHS covers acute only. Private treatment £3,000–£15,000+.

Strong integrative medicine tradition. Borreliose-Gesellschaft guidelines allow long-term therapy.

Acute care

Doxycycline or ceftriaxone IV (2–3 weeks) for neuroborreliosis.

Chronic care

Pulsed antibiotic combinations + hyperthermia (Klinik St. Georg, BCA-clinic).

Herbal & integrative

Cistus incanus, Cardus marianus, Samento — commonly prescribed alongside antibiotics.

Insurance

Statutory insurance covers acute; private/self-pay for hyperthermia and long courses.

Conservative public system, world-class private integrative clinics.

Acute care

Doxycycline or ceftriaxone per Swiss Society for Infectious Diseases.

Chronic care

Paracelsus Clinic, Swiss Mountain Clinic — ozone, IV vitamin C, peptides, bioresonance.

Herbal & integrative

Phytotherapy strongly integrated; Spagyric remedies common.

Insurance

Public covers acute. Integrative care CHF 5,000–25,000+.

Public healthcare follows short-course protocol; no chronic Lyme recognition.

Acute care

Doxycycline 10–14 days; ceftriaxone for neuroborreliosis.

Chronic care

Not treated in public system. Patients travel to Germany or use private integrative practitioners.

Herbal & integrative

Not reimbursed; limited availability of specialist herbalists.

Insurance

Free acute care; chronic treatment fully out-of-pocket abroad.

CBO/RIVM guidelines follow short-course model; chronic Lyme not formally recognized. Active patient advocacy via Lymevereniging Nederland.

Acute care

Doxycycline 10–14 days; ceftriaxone IV 14–28 days for neuroborreliosis or Lyme arthritis.

Chronic care

Not treated in public system after PLEASE trial. Patients use DualDur through ParasiteClinic.com or find knowledgeable local Drs.

Herbal & integrative

Not reimbursed; some naturopaths offer Buhner/Cowden protocols privately.

Insurance

Basisverzekering covers acute antibiotics; chronic and integrative care fully self-pay (€2,000–€20,000+).