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. 2020 Mar 2;10:3798. doi: 10.1038/s41598-020-59600-4

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© The Author(s) 2020

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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Azlocillin killing doxycycline-tolerant B. burgdorferi. (A) A log phase culture and (B) stationary phase culture. The B. burgdorferi were treated different concentrations of doxycycline (2.5, 5 and 10 μg/ml) for 3 days, pelleted, washed and then treated again with doxycycline and azlocillin (20 and 40 μg/ml). After 5 days the cultures were taken, washed, diluted, and plated on semisolid BSK-II medium for CFU counts (n = 3). Statistically significant difference between groups by two-way ANOVA followed by Tukey’s multiple comparisons test are indicated by ****p < 0.0001, ***p < 0.0003, and **p < 0.0088. Hash symbol represent eradication to the limit of detection. In the figure legend, Doxy persisters (doxycycline persisters), Doxy-tolerant Bb (doxycycline-tolerant B. burgdorferi), doxy-resuspension (B. burgdorferi treated again with doxycycline), Azlo 20 (20 μg/ml of azlocillin) and Azlo 40 (20 μg/ml of azlocillin).