Prophylaxis with Single-Dose Doxycycline for the Prevention of Lyme Disease after an Ixodes scapularis Tick Bite

• Published in: The New England journal of medicine Vol. 345; no. 2; pp. 79 - 84
• Main Authors: Nadelman, Robert B, Nowakowski, John, Fish, Durland, Falco, Richard C, Freeman, Katherine, McKenna, Donna, Welch, Peter, Marcus, Robert, Agüero-Rosenfeld, Maria E, Dennis, David T, Wormser, Gary P
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Boston, MA Massachusetts Medical Society 12.07.2001
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Animals; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - adverse effects; Antibacterial agents; Antibiotic Prophylaxis; Antibiotics; Antibiotics. Antiinfectious agents. Antiparasitic agents; Bacterial diseases; Biological and medical sciences; Bites and Stings; Borrelia burgdorferi; Borrelia burgdorferi Group - isolation & purification; Borrelia infections; Child; Clinical trials; Double-Blind Method; doxycycline; Doxycycline - administration & dosage; Doxycycline - adverse effects; Drug therapy; Erythema Chronicum Migrans - prevention & control; Female; Human bacterial diseases; Humans; Infectious diseases; Ixodes - growth & development; Ixodes scapularis; Ixodidae; Lyme disease; Lyme Disease - prevention & control; Lyme Disease - transmission; Male; Medical sciences; Middle Aged; Nymph; Pharmacology. Drug treatments; Preventive medicine; Tropical bacterial diseases; USA, New York; Lyme disease; Chemoprophylaxis; Spirochaetaceae; Toxicity; Ixodes scapularis; Prevention; Acari; Bacteria; Adult; Ixodidae; Spirachaetosis; Human; Parasitiformes; Borrelia burgdorferi; Spirochaetales; Treatment efficiency; Tetracycline derivatives; Borrelia infection; Single dose; Infection; Arachnida; Chemotherapy; Treatment; Ixodida; Arthropoda; Doxycycline; Bacteriosis; Double blind study; Invertebrata
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJM200107123450201

This large trial shows the efficacy of a single, prophylactic dose of doxycycline to prevent Lyme disease. Lyme disease is transmitted by the bite of an Ixodes scapularis tick and is the most common vector-borne disease in the United States. 1 This infection may be prevented by vaccination. 2 , 3 However, the vaccine's general acceptance is likely to be limited by its cost (a cost to the pharmacist of $61.25 per dose) and the need for multiple doses to achieve and maintain protection. 2 , 3 In addition, the vaccine is less than 100 percent effective and is currently approved only for persons 15 to 70 years of age. 3 Antimicrobial prophylaxis for persons with I. scapularis tick bites may be a . . .