A lthough there are controversies in Lyme disease and differing viewpoints among this Working Group, I do believe that all sides would agree that early diagnosis and treatment of tick-borne disease is a good thing. Yet, many factors stand in the way of prompt diagnosis. Here are two of them.

Single dose of Doxycycline Will Prevent Lyme Disease?

Doxycycline for Lyme treatmentMy first point concerns the dubious belief that a single dose of the antibiotic doxycycline given within 72 hours of a known tick bite will prevent Lyme disease. This is based on exactly one study by Nadelman, published in 2001. In it, fewer people developed an EM rash if given a single dose of doxycycline than if given a placebo. Anyone who didn’t develop an EM was presumed not to have Lyme disease (though we know that many Lyme patients never see a rash). Furthermore, they didn’t look for co-infections, and the observation period was a scant six weeks. So, nobody actually knows whether any of these people got sick later or not.

Despite the glaring weaknesses of that study, the one-dose doxy recommendation was enshrined in the IDSA’s 2006 Lyme guidelines … and further replicated in the Journal of Emergency Medicine, as recently as 2017. It’s also repeated on the CDC website.

I have heard from many people who were treated with a single dose of doxy and then went on to develop symptoms of Lyme and coinfections. Clearly, this unfortunate recommendation delays appropriate treatment—to the detriment of patients. It should be abolished…….. Join or login below to continue reading.

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