From the Guidelines
There is no clear recommendation for or against the use of antibiotics in patients with Southern Tick-Associated Rash Illness (STARI) due to a knowledge gap, as stated in the 2020 guidelines by the Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), and American College of Rheumatology (ACR) 1. When considering treatment for STARI, it's crucial to distinguish it from Lyme disease, especially in areas where both conditions are endemic.
- The guidelines suggest that if STARI cannot be distinguished from Lyme disease-associated erythema migrans in areas endemic for both conditions, antibiotic therapy directed toward Lyme disease is indicated 1.
- However, the specific antibiotic regimen for STARI is not clearly defined in the guidelines.
- In clinical practice, the approach might involve considering the use of antibiotics similar to those used for Lyme disease, such as doxycycline or amoxicillin, but this is not explicitly recommended for STARI in the provided guidelines.
- It's essential to consult with a healthcare provider for personalized advice, as the decision to treat with antibiotics should be made on a case-by-case basis, taking into account the patient's specific situation and the potential risks and benefits of treatment.
From the Research
Southern Tick-Associated Rash Illness (STARI) Treatment
- The recommended treatment for STARI is not explicitly stated in the provided studies, but based on the information available, treatment with doxycycline is considered prudent 2.
- Doxycycline is an oral antibiotic that is commonly used to treat various tick-borne illnesses, including Lyme disease 3, 4.
- The duration of treatment for STARI is not specified, but for Lyme disease, treatment typically lasts for 10 to 14 days 5 or 3 to 4 weeks 3.
- It is essential to differentiate STARI from Lyme disease, as the treatment and prognosis may differ 2.
- In some cases, STARI may not respond to antibiotics used to treat Lyme disease, and further investigation may be necessary to establish a diagnosis 6.
Key Considerations
- STARI is a form of erythema migrans, an annular rash with central clearing, similar to the rash seen in Lyme disease 2.
- The etiologic agent of STARI is unknown, but it may be a Borrelia species, and the tick vector is different from that of Lyme disease 2.
- Serious systemic complications are not currently recognized with STARI, but treatment with doxycycline is still recommended as a precautionary measure 2, 4.