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The advantage of benzathine penicillin intramuscularly is that parenteral penicillin therapy has been shown to be effective in the treatment of Lyme disease and Lyme arthritis [101,102], and as opposed to oral regimens with varying peak and trough levels, sustained therapeutic levels of benzathine penicillin may be effective by inhibition of germ replication or by lysis of the spirochetes leaving their sanctuaries [102]