The value of early treatment of deer tick bites for the prevention of Lyme disease
F. Agre and R. Schwartz
Department of Pediatrics, College of Physicians & Surgeons, Columbia University, Columbia-Presbyterian Medical Center, New York, NY.
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.
