Symptoms And Treatment Of Lyme Disease - 1454 Words

Introduction Lyme disease has been the most commonly reported vector-borne illness in the United States since the Centers for Disease Control and Prevention started reporting it in 1991 [1]. It should be noted that Lyme disease does not occur everywhere in the US, and is heavily concentrated in upper Midwest and northeast United States [1]. This report has been compiled to provide recommendations for antimicrobial prophylactic treatment of Lyme disease once a patient encounters a tick bite. Lyme disease is a multisystem inflammatory disorder caused by the spirochete Borrelia burgdorferi, which is transmitted by Ixodes dammini. [3]. I. dammini is commonly known as and referred to as the deer tick. Lyme disease can affect many organ systems†¦show more content†¦burgdorferi and Lyme disease cannot be acquired. Throughout the last decade the prevention of Lyme disease has been very controversial. Serological testing, vaccines, and antimicrobial therapy are highly researched areas, but only antimicrobial therapy has been proven useful for the prevention of Lyme disease. Serologic testing has not been proven to be effective in identifying B. burgdorferi and is not recommended. There are little to no antibodies present when a tick bite is encountered, thus serological testing will be negative. Any positive serological testing is highly probable for a false-positive, or the patient has had been bit prior to this encounter and already has Lyme disease [22]. Although a vaccine does exist, its cost and multiple doses needed to achieve immunity have limited its acceptability by the medical community [20, 21]. Antimicrobial therapy has been at the forefront of research in trying to identify if prophylactic treatment is necessary, what drug is most successful, and what 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 [2]. Either 250mg of amoxicillin or a placebo was given to subjects three times a day for ten days. 15 subjects dropped out and 7