Management of tick bites and early Lyme disease: A survey of Connecticut physicians

Practice guidelines have been published for the treatment of Lyme disease ( LD). These guidelines have been challenged as inadequate. Two common LD man agement problems are antibiotic prophylaxis of deer tick bites (deer ticks may carry Borrelia burgdorferi, the spirochete that causes LD) and antibiot ic treatment of erythema migrans, the pathognomonic rash of LD. A 1-page qu estionnaire was sent to a 13% (573/4300) sample of Connecticut physicians t o define how they treat deer tick bites and erythema migrans. Questionnaire s were returned by 320 (56%) of 573 physicians. Questionnaires were analyze d for the 267 physicians who saw patients with LD. Seventy (26%) of the 267 surveyed physicians prescribed antibiotic prophylaxis for patients with ti ck bites. B burgdorferi serology was ordered by 31% of physicians for patie nts with tick bites. Most surveyed physicians treated erythema migrans with doxycycline or amoxicillin for a mean of 21 days. Serology was ordered by 49% of physicians for patients with erythema migrans. Most physicians did n ot use prophylaxis for patients with deer tick bites. In addition, most of the physicians surveyed followed established guidelines for treating patien ts with erythema migrans. However, many of the physicians surveyed do serol ogic testing for patients with tick bites and/or erythema migrans. Serologi c testing for these patients is usually not necessary.