Prevention of Lyme disease after tick bites. 
Author Message
 Prevention of Lyme disease after tick bites.

Patient choice/preference notwithstanding....

N Engl J Med 1992 Aug 20;327(8):534-41

Prevention of Lyme disease after tick bites.
A cost-effectiveness analysis.
Magid D, Schwartz B, Craft J, Schwartz JS

Emergency Medical Services, Denver General Hospital.

BACKGROUND. In areas of endemic disease, the probability
of Lyme disease after a tick bite ranges from about 0.012
to 0.05. Early treatment with {*filter*}antibiotics prevents
most complications of Lyme disease, but antibiotics are
generally not prescribed until rash or other symptoms develop.
METHODS. We used decision analysis to evaluate the outcomes,
costs, and cost effectiveness of three alternative strategies
to treat patients bitten by ixodes ticks in areas of endemic
Lyme disease:  empirically treat all patients with two weeks
of doxycycline, treat only patients in whom erythema migrans
develops, and treat only patients with erythema migrans or a
positive serologic test for Lyme disease one month after
exposure. RESULTS. Empirical treatment is the least expensive
strategy and results in the fewest cases of Lyme disease and
the fewest complications when the probability of Borrelia
burgdorferi infection after a tick bite is 0.036 or higher. For
probabilities of infection below 0.036, empirical therapy
prevents most major complications, sequelae, and adverse
 events, but it incurs additional minor complications, especially
as the probability of infection falls below 0.01.
CONCLUSIONS. Empirical treatment of patients with tick bites is
indicated when the probability of B. burgdorferi infection after
a bite is 0.036 or higher, and this treatment may be
 preferred when the probability of infection ranges from 0.01
to 0.035. When the probability of infection after a tick bite
is less than 0.01, empirical therapy is not warranted.



Mon, 05 May 2003 03:00:00 GMT
 Prevention of Lyme disease after tick bites.
I am constantly amazed that there is even a debate about treating people for
4-6 weeks or not treating after known exposure to ticks.  

My vet will treat dogs for that long without hesitation and without evidence of
infection. And, without testing - she says the tests are so poor there's no
point in bothering.

Is treating dogs without regard to "probability" or "testing" more acceptable
because an insurance company isn't picking up the tab for the medication?
Hmmmmmm.

(By the way, I am thankful that dogs get help like this - I would hate for any
person or animal to suffer with this awful disease.)



Mon, 05 May 2003 03:00:00 GMT
 Prevention of Lyme disease after tick bites.
Also see:

Antibiotic Prophylaxis After Tick Bite For Prevention Of Lyme Disease -
Annotated Bibliography
http://www.geocities.com/HotSprings/Oasis/6455/prophylaxis-biblio.html

which is part of:

Annotated Bibliographies of Medical and Scientific Articles on
Lyme Disease Issues
http://www.geocities.com/HotSprings/Oasis/6455/bibliographies-links.html

which is part of:

Lots Of Links On Lyme Disease
http://www.geocities.com/HotSprings/Oasis/6455/lyme-links.html

-----
Art Doherty
Lompoc, California



Mon, 05 May 2003 03:00:00 GMT
 
 [ 3 post ] 

 Relevant Pages 

1. Antibiotic Prophylaxis After Tick Bite For Prevention Of Lyme Disease - An Annotated Bibliography

2. Tick Bites and Lyme Disease in an Endemic Setting

3. Antibiotic Treatment of Tick Bite Prevents ONLY 20% of Lyme Disease: D Fish

4. Disseminated Lyme disease after short-duration tick bite

5. Multiple Mosquito bites cause Lyme Disease (ticks too!)

6. Lyme Disease Transmission by Tick Bite

7. Ross has chronic Lyme Disease from a black dear tick bite and is wheel chair dependent

8. bitten by a deer tick, slipped into a coma with a form of Lyme disease

9. 86% OF PERSONS WITH LYME DISEASE ARE UNAWARE OF THE CAUSATIVE TICK BITE

10. Lyme disease - How a tick bite destroyed the career of an athletics champion

11. ?Lyme disease/tick - a bit urgent

12. Tick, Tick, Tick: Lyme disease problematic but preventable


 
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