Get It Right!  Treat The Bite!

Everyone agrees... 

The sooner treatment begins after a bite by an infected tick the better! 

Ticks live in dirt and consume blood from a number of animals that can carry multiple disease causing organisms.  Ticks are known to be infected with pathogens that can spread through the body quickly and cause a variety of mild to life-threatening symptoms.  

Forget the old "wait and see if you get sick" theory, treat the bite! 

Once tick borne organisms become entrenched in your body it is more draining on your health and your wallet trying to get rid of them, if you can.

A full panel of tick borne disease testing costs approximately $3,000.00 per person.  

Don't waste your money on blood tests immediately after a tick bite!  The tests for Lyme disease have been proven to miss 75% (or more) of people who are infected, and nearly everyone will test negative within the first 1-3 weeks after a tick bite (barring prior exposure).  Other tick borne disease tests leave a lot to be desired and often produce false-negative results.   

According to a 1998 study, treatment for early Lyme disease averaged $161 per patient, and longstanding Lyme disease averaged $61,243 per patient, per year.


Get it Right... TREAT THE BITE!

NEW Lyme Disease Treatment Guidelines- 2014

(Very Limited Excerpts Only- To Provide A Basic Overview) 

Introduction- The IDSA Lyme disease treatment guidelines have not been updated since they were written in 2005.  There have been many scientific publications, clinical trials and another decade of observing and data collecting that is available now to potentially improve the outcome of those contracting Lyme disease.  Some of the conclusions, based on the most recent science and clinical observations, are:

“Clinicians should not use a single 200 mg dose of doxycycline for Lyme disease prophylaxis. Clinicians should promptly offer antibiotic prophylaxis for known Ixodes tick bites in which there is evidence of tick feeding, regardless of the degree of tick engorgement or the infection rate in the local tick population. The preferred regimen is 100–200 mg of doxycycline, twice daily for 20 days. Other treatment options may be appropriate on an individualized basis.  Most patients will place a high value on preventing chronic illness.   

Treatment regimens of 20 or fewer days of phenoxymethyl-penicillin, amoxicillin, cefuroxime or doxycycline and 10 or fewer days of azithromycin are not recommended for patients with EM [Lyme] rashes because failure rates in the clinical trials were unacceptably high.  Failure to fully eradicate the infection may result in the development of a chronic form of Lyme disease, exposing patients to its attendant morbidity and costs, which can be quite significant.

Clinicians should prescribe amoxicillin, cefuroxime or doxycycline as first-line agents for the treatment of EM. Azithromycin is also an acceptable agent, particularly in Europe, where trials demonstrated it either outperformed or was as effective as the other first-line agents [46–49]

Initial antibiotic therapy should employ 4–6 weeks of amoxicillin 1500–2000 mg daily in divided doses, cefuroxime 500 mg twice daily or doxycycline 100 mg twice daily or a minimum of 21 days of azithromycin 250–500 mg daily. 

Pediatric dosing for the individual agents is as follows: amoxicillin 50 mg/kg/day in three divided doses, with a maximal daily dose of 1500 mg; cefuroxime 20–30 mg/kg/day in two divided doses, with a maximal daily dose of 1000 mg and azithromycin 10 mg/kg on day 1 then 5–10 mg/kg daily, with a maximal daily dose of 500 mg. 

For children 8 years and older, doxycycline is an additional option. Doxycycline is dosed at 4 mg/kg/day in two divided doses, with a maximal daily dose of 200 mg. Higher daily doses of the individual agents may be appropriate in adolescents.

Selection of the antibiotic agent and dose for an individual patient should take several factors into account. In the absence of contraindications, doxycycline is preferred when concomitant Anaplasma or Ehrlichia infections are possibilities. Other considerations include the duration [27,32,50] and severity [50–53] of symptoms, medication tolerability, patient age, pregnancy status, co-morbidities, recent or current corticosteroid use [54,55] cost, the need for lifestyle adjustments to accommodate certain antibiotics and patient preferences. 

Variations in patient-specific details and the limitations of the evidence imply that clinicians may, in a variety of circumstances, need to select therapeutic regimens utilizing higher doses, longer durations or combinations of first-line agents.

Clinicians should continue antibiotic therapy for patients who have not fully recovered by the completion of active therapy. Ongoing symptoms at the completion of active therapy were associated with an increased risk of long-term failure in some trials and therefore clinicians should not assume that time alone will resolve symptoms. There is a wide range of options and choices must be individualized, based on the strength of the patient’s initial response.

Disease progression or recurrence suggests that the iv. antibiotics or injectable penicillin G benzathine, as discussed previously, may be required. For patients requiring antibiotic therapy beyond the initial treatment period, subsequent decisions regarding the modification or discontinuation of treatment should be based on the therapeutic response and treatment goals.

Clinicians should retreat patients who were successfully treated initially but subsequently relapse or have evidence of disease progression. Therapeutic options include repeating the initial agent, changing to another oral agent or instituting injectable penicillin G benzathine or iv. ceftriaxone therapy. Choices must be individualized and based on several factors, including: the initial response to treatment; the time to relapse or progression; the current disease severity and the level of QoL impairments.

Disease relapse or progression with mild manifestations or QoL impairments occurring within a few months of treatment suggests a need for longer regimens using either tetracycline, a combination of oral first-line agents, injectable penicillin G benzathine or iv. ceftriaxone. 

Regardless of the duration of disease latency, when disease manifestations or QoL impairments are significant or rapidly progressive, injectable penicillin G benzathine or iv. ceftriaxone may be required.”

 

Evidence assessments and guideline recommendations in Lyme disease: the

clinical management of known tick bites, erythema migrans rashes and

persistent disease.    September 2014, Vol. 12, No. 9 , Pages 1103-1135 (doi:10.1586/ 14787210.2014.940900) Daniel J CameronLorraine B Johnson, and Elizabeth L Maloney  PDF (633 KB)   PDF Plus (639 KB) 1 International Lyme and Associated Diseases Society, PO Box 341461, Bethesda MD, 20827-1461,  USA 2 LymeDisease.org, PO Box 1352, Chico, CA 95927, USA  3 Partnership for Healing and Health Ltd, PO Box 84, Wyoming, MN 55092, USA  *Author forcorrespondence: +1 914 666 4665 contact@danielcameronmd.com

PLEASE READ THE FULL SET OF TREATMENT GUIDELINES AT THE FOLLOWING LINK. http://informahealthcare.com/doi/full/10.1586/14787210.2014.940900



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From Advanced Topics in Lyme Disease, by Dr. Joseph Burrascano, Page 19 & 20 


"TICK BITES - Embedded Deer Tick With No Signs or Symptoms of Lyme (see appendix): 

Decide to treat based on the type of tick, whether it came from an endemic area, how it was removed, and length of attachment (anecdotally, as little as four hours of attachment can transmit pathogens).  

The risk of transmission is greater if the tick is engorged, or of it was removed improperly allowing the tick's contents to spill into the bite wound.  High-risk bites are treated as follows (remember the possibility of co-infection!): 

 

1) Adults:  Oral therapy for 28 days.

 

2) Pregnancy:  Amoxicillin 1000 mg q6h for 6 weeks.  Test for Babesia, Bartonella and Ehrlichia.  
  Alternative: Cefuroxime axetil 1000 mg q12h for 6 weeks.

 

3) Young Children:  Oral therapy for 28 days. 

 

EARLY LOCALIZED - Single erythema migrans with no constitutional symptoms: 

1) Adults:  oral therapy- must continue until symptom and sign free for at least one month, with a 6 week minimum.

 

2) Pregnancy:  1st and 2nd trimesters:  I.V.  X 30 days then oral X 6 weeks 3rd trimester:  Oral therapy X 6+ weeks as above.  Any trimester- test for Babesia and Ehrlichia 

3) Children:  oral therapy for 6+ weeks." 

[About the Author- Dr. Joseph Burrascano lives and works in one of the most endemic areas of the country and has treated over 11,000 people suffering from Lyme and tick borne diseases.  He has over 25 years experience in the therapeutic areas of Internal Medicine and Infectious Diseases.  Dr. Burrascano also has a wide range of experience with clinical trials and has also been a contributing author to numerous scientific articles for both the lay and peer-reviewed press.]

For more information from Dr. Burrascano about treating people with Lyme and tick borne diseases, please click HERE


A printable version of NEW Lyme Disease Treatment Guidelines is on a PDF below.  

A printable version of Dr. Burrascano's Treatment Guidelines 

(Treating Tick Bites & Rashes) also can be found there.



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