Effectiveness of Stevia Rebaudiana Whole Leaf Extract Against the Various Morphological Forms of Borrelia Burgdorferi in Vitro

Lyme disease is a tick-borne multisystemic disease caused by Borrelia burgdorferi. Administering antibiotics is the primary treat-ment for this disease; however, relapse often occurs when antibiotic treatment is discontinued. The reason for relapse remains un-known, but recent studies suggested the possibilities of the presence of antibiotic resistant Borreliapersister cells and biofilms.In this study, we evaluated the effectiveness of whole leaf Stevia extract against B. burgdorferispirochetes, persisters, and bio-film forms in vitro. The susceptibility of the different forms was evaluated by various quantitative techniques in addition to differ-ent microscopy methods. The effectiveness of Stevia was compared to doxycycline, cefoperazone, daptomycin, and their combina-tions. Our results demonstrated that Stevia had significant effect in eliminating B. burgdorferi spirochetes and persisters. Sub-culture experiments with Stevia and antibiotics treated cells were established for 7 and 14 days yielding, no and 10% viable cells, respectively compared to the above-mentioned antibiotics and antibiotic combination. When Stevia and the three antibiotics weretested against attached biofilms, Stevia significantly reduced B. burgdorferiforms. Results from this study suggest that a natural product such as Stevia leaf extract could be considered as an effective agent against B. burgdorferi.