USE ANTIBIOTICS TO TREAT TICK BITE?
Report #6824 5/30/96
You just found a tick on your skin and worry that you could get Lyme disease. You know that Lyme disease often cannot be cured when it causes arthritis many months later. Should you take antibiotics to prevent Lyme disease?
A week or two after a tick bite, a person can develop muscle aches, fever and tiredness. He may or may not develop the diagnostic sign of Lyme disease: a red circle around the red dot where he was bitten. Doctors often prescribe ampicillin or doxycycline antibiotics to prevent nerve damage and arthritis. Even with treatment, some people will suffer severe arthritis several months later (2), while others may suffer nerve damage characterized by loss of feeling in one part of their body, muscle paralysis or even severe headaches. Doctors usually treat people with Lyme arthritis or nerve damage with antibiotic injections and some people will get better, but more than 25% of people with arthritis will continue to suffer joint pains (1,4,5). Blood tests are dependable, but some people with florid Lyme arthritis have negative blood tests for Lyme disease, so it is extremely difficult to make the diagnosis (1). Since no antibiotic treatment regimens are always effective in treating Lyme disease once it occurs, many doctors now prescribe ampicillin or doxycycline for one to two weeks to people who remove blood-filled ticks from their skin (7).
By Gabe Mirkin, M.D., for CBS Radio News
1) The patients had clinical disease with or without diagnostic antibody titers to B,
burgdorferi. VP Mursic, W Marget, U Busch, DP Rigler, S Hagl. Kill kinetics of Borrelia
burgdorferi and bacterial findings in relation to the treatment of lyme borreliosis.
Infection 24: 1 (JAN-FEB 1996):9-16.
2) Patients with erythema migrans can fail to respond to antibiotic therapy, Persistent
or recurrent erythema migrans, major sequelae such as meningitis and arthritis, survival
of Borrelia burgdorferi and significant and persistent increase of antibody titres against
B. burgdorferi after antibiotic therapy are strong indications of a treatment failure,
Most, if not all, antibiotics used so far have been associated with a treatment failure in
patients with erythema migrans, Roxithromycin and erythromycin are definitely or probably
ineffective. However, doxycycline, amoxicillin, cefuroxime, ceftriaxone, azithromycin and
high-dose penicillin V perform comparably well. K Weber. Treatment failure in erythema
migrans - A review. Infection 24: 1 (JAN-FEB 1996):73-75.
3) Antibiotic treatment is the cornerstone of Lyme arthritis treatment. MA Cimmino, GL
Moggiana, M Parisi, S Accardo. Treatment of Lyme arthritis. Infection 24: 1 (JAN-FEB
1996):91-94.
4) W Graninger. A ''minority'' opinion about the diagnosis and treatment of Lyme
arthritis. Infection 24: 1 (JAN-FEB 1996):95-97.
5) 35 patients with late stage Lyme borreliosis with involvement of the joints was
followed up until 3 years after a 14 day course of 2 g ceftriaxone once daily i.v. Long
term clinical results in 26 patients at 36 months were complete response or marked
improvement in 19, relapse in six and new manifestations in four of the cases,
respectively. M Valesova, H Mailer, J Havlik, D Hulinska, J Hercogova. Long-term results
in patients with Lyme arthritis following treatment with ceftriaxone. Infection 24: 1
(JAN-FEB 1996):98-102.
6) Ehrlichiosis. J. Stephen Dumler, M.D. U of Maryland. Johan Bakken Deluth Clinic,
Deluth, Minn. JAMA. July 20, 1994 and January 5, 1995.
7) GP Wormser. Controversies in the use of antimicrobials for the prevention and treatment of Lyme disease. Infection 24: 2 (MAR-APR:1996):178-181.