Treat The Bite!
Everyone Agrees- the sooner treatment begins after a bite by an infected tick, the better! Ticks live in the dirt and consume blood from a number of wild and domesticated animals that can carry and transmit multiple disease causing organisms. Ticks are known to be infected with multiple pathogens that can spread throughout the body quickly and cause a variety of mild to life-threatening symptoms. Waiting to see if the tick borne infections spread through your body, or if you get a rash, or if you get sick after a tick bite does NOT make sense. Forget the old "wait and see" approach!
Remember- Less than 50% of people with Lyme disease get a rash and many do not notice any early symptoms. Less than 10% of children get a rash. Less than half of the people with reported cases of Lyme disease recalled being bitten by a tick.
GET IT RIGHT... TREAT THE BITE!
Once tick borne disease organisms are entrenched in your body it is more costly to both your health and your wallet to get rid of them, if you can. An ounce of prevention in this case can be worth a pound of cure!
Never depend on Lyme tests performed within a month of a tick bite! Nearly everyone will test negative for Lyme disease within the first 1-4 weeks after being bitten by an infected tick (barring prior exposure). It takes weeks for your body to produce enough antibodies to the Lyme bacterium to be able to get a positive test result using the current tests and testing methods, if you ever get a positive test at all. Remember...
Tests for Lyme disease miss 75% (or more) of people who are infected!
The CDC states for every case of Lyme disease reported, ten are being missed. Depending on unreliable tests to establish a "reported case" of Lyme disease allows even more cases to go undiagnosed, untreated and unreported, and more people to suffer with chronic Lyme disease.
According to a 1998 scientific study, treatment for early Lyme disease averaged $161 per patient. A patient with longstanding (chronic) Lyme disease spends an average of $61,243 per year, each year, with most insurances refusing to pay the bills. Can you really afford to "wait and see"? No, of course not!
Advanced Topics In Lyme Disease
Dr. Joseph Burrascano, Jr.
Embedded Deer Tick With No Signs or Symptoms of Lyme
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.
WHEN YOU HAVE A RASH
Single erythema migrans [Lyme rash] 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.
ANTIBIOTIC CHOICES AND DOSES
ORAL THERAPY: Always check blood levels when using agents marked with an *, and adjust dose to achieve a peak level above ten and a trough greater than three. Because of this, the doses listed below may have to be raised. Consider Doxycycline first in early Lyme due to concern for Ehrlichia co-infections.
*Amoxicillin- Adults: 1g q8h plus probenecid 500mg q8h; doses up to 6 grams daily are often needed
Pregnancy: 1g q6h and adjust.
Children: 50 mg/kg/day divided into q8h doses.
*Doxycycline- Adults: 200 mg bid with food; doses of up to 600 mg daily are often needed, as doxycycline is only effective at high blood levels. Not for children or in pregnancy. If levels are too low at tolerated doses, give parenterally or change to another drug.
SOURCE: ADVANCED TOPICS IN LYME DISEASE. DIAGNOSTIC HINTS AND TREATMENT GUIDELINES FOR LYME AND OTHER TICK BORNE ILLNESSES Sixteenth Edition. Copyright October, 2008. JOSEPH J. BURRASCANO JR., M.D. Board Member, International Lyme and Associated Diseases Society [MANAGING LYME DISEASE, 16h edition, October, 2008 Page 18 of 37]
About the Author- Dr. Joseph Burrascano lives and worked in one of the most endemic areas of the country. He has treated over 11,000 people for 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 been a contributing author to numerous scientific articles for both the lay and peer-reviewed press.
Dr. Joseph Burrascano's Advanced Topics in Lyme Disease
For a one page PRINTABLE document to take with you to your doctor
Please click on the PDF link below.
Last Updated: June 2014
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