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Article |

The Value of Early Treatment of Deer Tick Bites for the Prevention of Lyme Disease FREE

Fred Agre, MD; Robert Schwartz, MD
[+] Author Affiliations

Accepted for publication February 25, 1993.

Presented as a poster exhibit at the Annual Meeting of the Ambulatory Pediatric Association, New Orleans, La, April 29, 1991.

Reprints not available.


Am J Dis Child. 1993;147(9):945-947. doi:10.1001/archpedi.1993.02160330035013.
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• Objective.  —To determine if the early antibiotic treatment of deer tick bites prevented Lyme disease.

Design.  —Prospective, double-blind, placebo-controlled, antibiotic treatment.

Setting.  —Private practice in an area endemic for Lyme disease.

Study Participants.  —Patients between 3 and 19 years of age who received antibiotic treatment within 3 days following a deer tick bite.

Interventions.  —Patients received an antibiotic or placebo and were followed up for stage I and II disease. All patients had blood drawn at the time of presentation and 6 weeks later for immunofluorescent antibodies (IFA).

Measurements/Main Results.  —One patient in the placebo group developed clinical Lyme disease associated with an IFA titer of 1:32, considered weakly positive. Three other patients in the placebo group developed an IFA titer of 1:32; one had an influenzalike illness and two had no symptoms. None of the study patients developed any neurologic, cardiac, or arthritic symptoms in the 1- to 3-year follow-up.

Conclusion.  —Based on the low frequency of illness, the absence of stage II disease, and the inability to establish the efficacy of early antibiotic treatment, we suggest that physicians not routinely use prophylactic antibiotics for deer tick bites.(AJDC. 1993;147:945-947)

REFERENCES

Harris ED.  Lyme disease success for academia and the community . N Engl J Med . 1983;;308:773-775.
Steere AC, Grodzicki RL, Kornblatt AN, et al.  The spirochetal etiology of Lyme disease . N Engl J Med . 1983;;308:733-740.
Steere AC, Malawista SE, Snydman DR, et al.  Lyme arthritis: an epidemic of oligoarticular arthritis in children and adults in three Connecticut communities . Arthritis Rheum . 1977;;20:7-17.
Centers for Disease Control.  Lyme surveillance: United States, 1989-1990 . MMWR Morb Mortal Wkly Rep . 1991;;40:41 7-421.
Lyme Disease Surveillance . Albany, NY: Division of Epidemiology, New York State Department of Health; 1989;;4:8.
Szer IS, Taylor E, Steere A.  The long-term course of Lyme arthritis in children . N Engl J Med . 1991;;325:159-163.
Hanner P, Rosenhall U, Edstrom S, Kaijer B.  Hearing impairment in patients with antibody production against Borrelia burgdorferi antigen . Lancet . 1989;;1:13-15.
Logigian EL, Kaplan RF, Steere AC.  Chronic neurologic manifestations of Lyme disease . N Engl J Med . 1990;;323:1438-1443.
Schwartz BS, Goldstein MD, Ribeiro JMC, Schulze TL, Shahied SL.  Antibody testing in Lyme disease . JAMA . 1989;;262:3431-3443.
Rose LD, Fancett PT, Singsen BH, Dubbs SB, Doughty RA.  Use of Western blot and enzyme-linked immunosorbent assay to assist in the diagnosis of Lyme disease . Pediatrics . 1991;;88:465-470.
Gerber MA, Shapiro F.  Diagnosis of Lyme disease in children . J Pediatr . 1992;;121:157-162.
Dattwyler RJ, Volkman DJ, Luft BJ, Halperin JJ, Thomas J, Golightly ME.  Seronegative Lyme disease . N Engl J Med . 1988;;319:1441-1446.
Committee on Infectious Disease. Report of the Committee on Infectious Disease . 21st ed. Evanston, Ill: American Academy of Pediatrics; 1986;: 225-226.
Costello CM, Steere AC, Pinkerton RE, Feder HM.  A prospective study on tick bites in an endemic area for Lyme disease . J Infect Dis . 1989;;159: 136-139.
Guy EC, Martyn CN, Bateman DE, Heckels JE, Lawton NF.  Lyme disease prevalence and clinical importance of Borrelia-specific IgG in forestry workers . Lancet . 1989;;1:484-485.
Shrestha M, Grodzicki RL, Steere AC.  Diagnosing early Lyme disease . Am J Med . 1985;;78:235-240.
Russell H, Sampson JS, Schmid GP, Wilkinson HW, Plikaytis B.  Enzyme-linked immunosorbent assay and indirect immunofluorescent assay for Lyme disease . J Infect Dis . 1984;;149:465-470.
Craft JE, Grodzicki RL, Steere AC.  Antibody response in Lyme disease: evaluation of diagnostic tests . J Infect Dis . 1984;;149:789-795.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

Harris ED.  Lyme disease success for academia and the community . N Engl J Med . 1983;;308:773-775.
Steere AC, Grodzicki RL, Kornblatt AN, et al.  The spirochetal etiology of Lyme disease . N Engl J Med . 1983;;308:733-740.
Steere AC, Malawista SE, Snydman DR, et al.  Lyme arthritis: an epidemic of oligoarticular arthritis in children and adults in three Connecticut communities . Arthritis Rheum . 1977;;20:7-17.
Centers for Disease Control.  Lyme surveillance: United States, 1989-1990 . MMWR Morb Mortal Wkly Rep . 1991;;40:41 7-421.
Lyme Disease Surveillance . Albany, NY: Division of Epidemiology, New York State Department of Health; 1989;;4:8.
Szer IS, Taylor E, Steere A.  The long-term course of Lyme arthritis in children . N Engl J Med . 1991;;325:159-163.
Hanner P, Rosenhall U, Edstrom S, Kaijer B.  Hearing impairment in patients with antibody production against Borrelia burgdorferi antigen . Lancet . 1989;;1:13-15.
Logigian EL, Kaplan RF, Steere AC.  Chronic neurologic manifestations of Lyme disease . N Engl J Med . 1990;;323:1438-1443.
Schwartz BS, Goldstein MD, Ribeiro JMC, Schulze TL, Shahied SL.  Antibody testing in Lyme disease . JAMA . 1989;;262:3431-3443.
Rose LD, Fancett PT, Singsen BH, Dubbs SB, Doughty RA.  Use of Western blot and enzyme-linked immunosorbent assay to assist in the diagnosis of Lyme disease . Pediatrics . 1991;;88:465-470.
Gerber MA, Shapiro F.  Diagnosis of Lyme disease in children . J Pediatr . 1992;;121:157-162.
Dattwyler RJ, Volkman DJ, Luft BJ, Halperin JJ, Thomas J, Golightly ME.  Seronegative Lyme disease . N Engl J Med . 1988;;319:1441-1446.
Committee on Infectious Disease. Report of the Committee on Infectious Disease . 21st ed. Evanston, Ill: American Academy of Pediatrics; 1986;: 225-226.
Costello CM, Steere AC, Pinkerton RE, Feder HM.  A prospective study on tick bites in an endemic area for Lyme disease . J Infect Dis . 1989;;159: 136-139.
Guy EC, Martyn CN, Bateman DE, Heckels JE, Lawton NF.  Lyme disease prevalence and clinical importance of Borrelia-specific IgG in forestry workers . Lancet . 1989;;1:484-485.
Shrestha M, Grodzicki RL, Steere AC.  Diagnosing early Lyme disease . Am J Med . 1985;;78:235-240.
Russell H, Sampson JS, Schmid GP, Wilkinson HW, Plikaytis B.  Enzyme-linked immunosorbent assay and indirect immunofluorescent assay for Lyme disease . J Infect Dis . 1984;;149:465-470.
Craft JE, Grodzicki RL, Steere AC.  Antibody response in Lyme disease: evaluation of diagnostic tests . J Infect Dis . 1984;;149:789-795.

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