Disease Control And Prevention Starting Reporting Lyme...

Introduction Since the Centers for Disease Control and Prevention starting reporting Lyme disease as a reportable disease in 1991 it has been the most commonly reported vector-borne illness is the United States1. It should be noted that Lyme disease does not occur everywhere in the US, and is heavily concentrated in upper Midwest and northeast United States1. This report has been compiled to provide recommendations for prophylactic treatment of Lyme disease once a patient encounters a tick bite. Lyme disease is caused by the spirochete Borrelia burgdorferi, which is transmitted by Ixodes dammini, otherwise known as the deer tick3. B. burgdorferi lives in the midgut of the deer tick, and becomes active after a tick’s gut is filled with†¦show more content†¦Serologic testing has not been proven to be effective in identifying B. burgdorferi. Antimicrobial therapy has been at the forefront of research in trying to identify if prophylactic treatment is necessary and what drug and dosing is most appropriate. Antimicrobial Prophylaxis In 1992 Shapiro et al. published their research informing providers prophylactic antimicrobial treatment is not routinely indicated.2 There were a total of 387 patients in the controlled trial, 203 patients assigned to receive amoxicillin and 182 were given a placebo. Either 250mg of amoxicillin or a placebo was given to subjects three times a day for ten days. 15 subjects dropped out and 7 subjects had already shown positive serologic testing to B. burgdorferi and were therefore dismissed from the study. Out of 173 subjects who received the placebo only two developed symptomatic infection with B. burgdorferi; whereas, none of the 192 subjects who were given amoxicillin showed any infection. They concluded the risk of actually becoming infected with B. burgdorferi is so small that the prophylactic use of antibiotics does not make a clinical significance and should not be used. The authors also indicated that most deer ticks are actually not infected with B. burgdorferi, which may he lp explain why so little placebo subjects showed a positive infection after their encounter. While Shapiro et al. was not able to recommend antimicrobial prophylaxis with amoxicillin Nadelman et al. devised