CHAPTER 43 DOXYCYCLINE IN LYME DISEASE

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

Nadelman RB, Nowakowski J, Fish D, et al. N Engl J Med. 2001;345(2):79–84

BACKGROUND

Lyme disease (Borrelia burgdorferi) is transmitted by the bite of the Ixodes scapularis tick and causes significant morbidity in endemic regions. Prior research into other spirochete infections such as syphilis and leptospirosis suggested benefit in prophylactic antimicrobial treatment of incubating spirochete infections. At the time of this study, it was unknown whether antimicrobial prophylaxis after an I. scapularis tick bite would prevent Lyme disease.

OBJECTIVES

To determine if primary prophylaxis with a single dose of doxycycline would prevent Lyme disease after an I. scapularis tick bite.

METHODS

Randomized, double-blind, placebo-controlled trial at a single academic medical center in Westchester County, NY between May 1987 and December 1996.

Patients

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