Monday, September 13, 2010

Top Lyme Doc Says Antibiotics for ANY tick bite

by Kim, SpiroChicks co-founder

Last week, I got this message from a friend on Facebook:

"Hey, we're on vacation and wife insisted that I send u a message. I pulled a deer tick out of my thigh 2 weeks ago. Big itchy spot at site now. no big ring. Kinda achy. How late is too late to be tested and start antibios if needed? So sorry to bother you with this, but wife worries a lot.”

There does seem to be a lot of confusion around what to do if you get a tick bite. And given my experience down the long, rutted, windy, washed out road of chronic Lyme, knowing that if I could change the past I would (i.e. eradicated the buggers before a deep set infection requiring YEARS of antibiotics set in), I wrote back: GO TO URGENT CARE AND GET ON ANTIBIOTICS ASAP. Then find an LLMD when you get home.

So for next time, you or I get a message like this, here's a post you can refer your friends and family to. The best resource out there is Dr. Burrascano's Advanced Topics in Lyme Disease from the International Lyme And Associated Diseases Society site. On page 19, He reccomends antibiotics for 28 days if you just get a tick bite, and six weeks if there's a rash. In the Appendix on page 32, is the rational for treating ANY tick bite:

RATIONALE FOR TREATING TICK BITES
Prophylactic antibiotic treatment upon a known tick bite is recommended for those who fit the following categories:


1. People at higher health risk bitten by an unknown type of tick or tick capable of transmitting Borrelia burgdorferi, e.g., pregnant women, babies and young children, people with serious health problems, and those who are immunodeficient.


2. Persons bitten in an area highly endemic for Lyme Borreliosis by an unidentified tick or tick capable of transmitting B. burgdorferi.


3. Persons bitten by a tick capable of transmitting B. burgdorferi, where the tick is engorged, or the attachment duration of the tick is greater than four hours, and/or the tick was improperly removed. This means when the body of the tick is squeezed upon removal, irritated with toxic chemicals in an effort to get it to back out, or disrupted in such a way that its contents were allowed to contact the bite wound. Such practices increase the risk of disease transmission.


4. A patient, when bitten by a known tick, clearly requests oral prophylaxis and understands the risks. This is a case-by-case decision.


The physician cannot rely on a laboratory test or clinical finding at the time of the bite to definitely rule in or rule out Lyme Disease infection, so must use clinical judgment as to whether to use antibiotic prophylaxis. Testing the tick itself for the presence of the spirochete, even with PCR technology, is helpful but not 100% reliable.


An established infection by B. burgdorferi can have serious, long-standing or permanent, and painful medical consequences, and be expensive to treat. Since the likelihood of harm arising from prophylactically applied anti-spirochetal antibiotics is low, and since treatment is inexpensive and painless, it follows that the risk- benefit ratio favors tick bite prophylaxis.

8 comments:

Alix said...

As most of you know, I only use Pharma drugs as a last resort, however, I would have done a month+ of antibiotics after my tick bite had I known it would ruin the next two decades++ of my life. It is devastating to think I had the rash and no one knew what it was at the time.

Thanks kim for posting Burrascano's guidelines. People ask me all the time what they should do. Most are in Lyme denial:

- "oh, I only got the ring around the rash for 24 hours then it went away" or

- "I was only out for an hour, so it couldn't have been a tick bite. It was probably a spider bite."

- "It was only attached for 24 hours, so I'm sure I'm ok."

- "only 5% of ticks in California are infected, so I don't need to treat unless I get a rash."

All those statements are potentially paths to disaster. We've all been through Lyme Denial. It doesn't serve anyone well in the prevention stage.

Erin Carroll-Sutton said...

I so agree with Alix! I hadn't taken antibiotics for over a decade, now I've been on crazy amounts for almost 20 months. I had a bullseye at the age of 21 and the doc didn't even test because it wasn't a deer tick. In retrospect, I see that I did have symptoms. However, it wasn't until after I had my daughter that the symptoms were undeniable. My first instinct was that it was Lyme but, as is common, the test was considered negative (even with one positive on the CDC test). So after a year of getting shipped from specialist to specialist and having way too many MRI's and CAT scans, I FINALLY got in with a Lyme doc. Even though I am 85% better, some of the damage could be permanent. This protocol is completely advisable. It doesn't have to get to the point that many of us have gotten to.

Geoff Granfield said...

Are those antibiotics advisable after undergoing a cosmetic dental surgery procedure? It scares me a bit after reading through. I hope you can shed light on this. Cheers!

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Derrick Patterson said...

Aside from the given solutions to tick bite, can anyone provide here the best sinus infection antibiotics? My son is now suffering from a sinus infection.

Anonymous said...

Thank you so much for posting this doc! It's exactly the info I was looking for.