Antimicrobial Prophylaxis after Tick Bites

To the Editor: We believe Shapiro et al. (Dec. 17 issue) 1 had inadequate evidence to support their recommendation for nontreatment of deer-tick bites. The population samples were much too small for a meaningful comparison of the risks of serious late sequelae with the risks and benefits of prophyla...

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Bibliographic Details
Published inThe New England journal of medicine Vol. 328; no. 19; pp. 1418 - 1420
Main Author Drachman, D A
Format Journal Article
LanguageEnglish
Published United States Massachusetts Medical Society 13.05.1993
Subjects
Amoxicillin - therapeutic use
Animals
Bites and Stings - complications
Cost-Benefit Analysis
Humans
Lyme Disease - economics
Lyme Disease - prevention & control
Ticks
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Summary:To the Editor: We believe Shapiro et al. (Dec. 17 issue) 1 had inadequate evidence to support their recommendation for nontreatment of deer-tick bites. The population samples were much too small for a meaningful comparison of the risks of serious late sequelae with the risks and benefits of prophylactic antibiotic therapy. Consider the hypothetical situation of 10,000 deer-tick bites in Connecticut, in which 120 people would acquire the disease and 15 to 36 would not manifest erythema migrans. Magid et al. 2 estimate that 60 percent of these people would acquire chronic arthritis, 17 percent meningoencephalitis or neuropathy, and 6 percent cardiac . . .
ISSN:0028-4793
1533-4406
DOI:10.1056/NEJM199305133281910