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Since the patient had never used a cell wall antibiotic (penicillins, cephalosporins) for Lyme disease and complained of significant neurocognitive symptoms, she was placed on IV ceftriaxone (Rocephin) 2 grams per day, ursodiol (Actigall) 300 milligrams PO BID, atovaquone (Mepron) 750 milligrams, 2 teaspoons PO BID with a high-fat meal, clarithromycin XL 500 milligrams BID, hydroxychloroquine (Plaquenil) 200 milligrams PO BID and nystatin 500,000 units tablets, 2 PO BID

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