There's no evidence that chronic Lyme exists:
> There is no evidence to suggest that “chronic Lyme” exists, or that long-term antibiotics are required to treat it.
(https://sciencebasedmedicine.org/avoid-prolonged-antibiotics...)
It's pseudoscientific and pretty dangerous nonsense at that.
> Several recent studies suggest that B. burgdorferi may persist in animals after antibiotic therapy.
There's also evidence that the standard Lyme treatment increases the "round bodies" form of the bacteria [2].
That being said, there's still a lot of shysters who, as you say, push long-term antibiotics or diagnose patients with "Lyme disease," despite not having evidence.
The CDC recognizes the existence of "Post-Treatment Lyme Disease Syndrome," but highlights that long-term antibiotics aren't a good solution [3].
[1]: https://www.niaid.nih.gov/diseases-conditions/chronic-lyme-d...
[2]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3132871/figure/...
> This study aimed to demonstrate that severe neurological motor deficits in the context of late tick-borne disease with mixed microorganism involvement are eligible for long-term combined antibiotic/antiparasitic treatments. The inclusion criteria were: 1. neurological limb paralysis with a disability score >4 according to the EDSS Kurtzke disability scale; 2. serological tests pointing to an involvement of the main tick-borne microorganisms Borrelia burgdorferi s.l., Babesia, Anaplasma, and Bartonella; 3. a general disease for more than 6 months with fatigue, pain and subjective cognitive deficit. The patients were administered long-term treatments with repeated cycles (at least three) of 35-day IV ceftriaxone and repeated oral regimens of azithromycin–doxycycline and azithromycin–doxycycline–rifampicin. For Babesia, repeated courses of atovaquone–azithromycin were administered. Ten patients had intractable or severe motor deficits before treatment in the context of Borrelia (two cases) Borrelia–Babesia (four cases), Borrelia–Babesia–Anaplasma (two cases), Borrelia–Babesia–Anaplasma–Bartonella (one case) and Babesia–Anaplasma (one case). For several months, five had been in wheelchairs, and four had been walking with sticks. Seven patients out of 10 (70%) showed complete remission after a mean active treatment duration of 20.1 + 6.6 months, with a mean number of 4 ceftriaxone cycles. Three patients showed an initial remission but suffered secondary antibiotic/antiparasitic-resistant motor recurrences. Among the nine patients with Borrelia serologic positivity, treatments obtained complete remission in seven cases (77%). The findings of this ten-case series suggest the usefulness of long-term antibiotic/antiparasitic treatments in patients with severe late tick-borne neurological deficits with highly significant elements of tick-borne involvement.
So “late untreated borreliosis” is a “real thing” but if someone gets borreliosis, gets treated, yet their symptoms persist (this scenario is what people usually mean by the term chronic Lyme) then that is NOT a “real thing”?
Does this mean that treatment is 100% effective or that if it didn’t work, then it wasn’t borreliosis to begin with?
What I have found is that all the bullshit medicine keeps similar company: Chronic Lyme, Bartonella, Biofilms, non-native Parasites, mold, heavy metals, and even emf sensitivity.