> Out of curiosity how come you have such detailed familiarity with the topic?

I developed the typical Lyme symptoms after spending a lot of time outdoors in a Lyme area and removing ticks from myself several different times. I tested positive for Lyme under the relatively strict CDC criteria from a trusted laboratory. A 28-day course of Doxycycline changed something, but the fatigue and general malaise stuck around. I've spent the next decade consuming every bit of research I could find on the topic.

I'd love as much as anyone for this already FDA-approved antibiotic like Azlocillin to be a miracle cure for my problems. I would gladly welcome properly structured RCTs. However, I've learned to be extremely skeptical of antibiotic therapies for Lyme. Patients who self identify as having "chronic Lyme" are notorious for holding strong beliefs that antibiotics improve their condition after reading about hidden spirochetes and undetectable infection theories for years, but double-blind studies show no benefit.

I think the much more likely explanation is that Lyme can trigger long-lasting alterations in the body somewhere, even after the infection is eliminated.

Sadly, the topic has become so political that mainstream researchers won't touch it. Now that "chronic Lyme" is so closely intertwined with the alternative medicine community, anyone who denies the persistent infection theory is treated as if they are denying the persistent symptoms of sufferers. That couldn't be farther from the truth for me, as I suffer the symptoms myself.

The topic is so politically charged that I only use my pseudonymous alternate account for discussing it online. I've had chronic Lyme sufferers dox me and send vaguely threatening messages in the past, just for discussing the research online. It's no wonder that more researchers don't want to investigate Lyme disease.

Hundreds of thousands of people have been diagnosed with Lyme, so probably millions know someone who has. There are posters about ticks at nearly every trailhead I've visited in the northeast US in the past five years. It's not obscure.

If you live somewhere that Lyme disease is prevalent (much of the eastern US) and spend any time doing outdoorsy stuff (or associate with people that do), it's hard not to be aware of Lyme disease. You'll also likely know people who have had it, and other people who have persistent symptoms after an infection.