The Emerging Role of Microbial Biofilm in Lyme Neuroborreliosis[1]: "The early treatment with oral antimicrobials is effective in the majority of patients with LNB. Nevertheless, persistent forms of LNB are relatively common, despite targeted antibiotic therapy. It has been observed that the antibiotic resistance and the reoccurrence of Lyme disease are associated with biofilm-like aggregates in B. burgdorferi, B. afzelii, and B. garinii, both in vitro and in vivo, allowing Borrelia spp. to resist to adverse environmental conditions. Indeed, the increased tolerance to antibiotics described in the persisting forms of Borrelia spp., is strongly reminiscent of biofilm growing bacteria, suggesting a possible role of biofilm aggregates in the development of the different manifestations of Lyme disease including LNB."
Persistent Borrelia Infection in Patients with Ongoing Symptoms of Lyme Disease[2]: "Using multiple corroborative detection methods, we showed that patients with persistent Lyme disease symptoms may have ongoing spirochetal infection despite antibiotic treatment, similar to findings in non-human primates. The optimal treatment for persistent Borrelia infection remains to be determined."
If you want to know more, here's a thorough critique of the current Lyme policies.[3]
[1]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6287027/ [2]https://www.ncbi.nlm.nih.gov/pubmed/29662016 [3]https://waset.org/Publications/obstruction-to-treatments-mee...
In January 2016, the NGC removed the Infectious Diseases Society of America (IDSA) guidelines on Lyme disease for these reasons. In a scathing report on the standard of clinical guidelines in North America, the Institute of Medicine specifically referenced the IDSA guidelines on Lyme disease as a prime example of what not to do. Now, the only evidence-based, peer-reviewed guidelines on Lyme disease that conform to (and exceed) the Institute of Medicine’s clinical guideline standards and are available on the NGC website, are the International Lyme and Associated Diseases Society guidelines for Lyme disease (ILADS). ILADS guidelines recognize persistent Lyme and have cured thousands of patients.
Meanwhile, the CDC is still promoting the ISDA guidelines that deny the evidence of persistent Lyme Disease. The CDC claims that these 2006 guidelines represent the "best science" and "the best synthesis of the available evidence". They do not provide the reference or criteria to substantiate this claim. And they are ignoring over 700 peer-reviewed articles that support the persistent Lyme theory.[1]
[1]https://www.ilads.org/wp-content/uploads/2018/07/CLDList-ILA...