From the Guidelines
The recommended treatment for a patient presenting with symptoms of a tick-borne disease common in Florida is doxycycline, typically prescribed at 100 mg twice daily for 10-14 days. This antibiotic is the first-line treatment for several tick-borne illnesses prevalent in Florida, including Rocky Mountain spotted fever, ehrlichiosis, and anaplasmosis 1. According to the CDC, doxycycline is the drug of choice for treatment of all tickborne rickettsial diseases in patients of all ages, including children aged <8 years, and should be initiated immediately in persons with signs and symptoms suggestive of rickettsial disease 1.
Some key points to consider when treating tick-borne diseases include:
- Doxycycline is recommended by the American Academy of Pediatrics and CDC as the treatment of choice for patients of all ages, including children aged <8 years, with a suspected tickborne rickettsial disease 1.
- Delay in treatment of tickborne rickettsial diseases can lead to severe disease and death 1.
- For mild cases of anaplasmosis, rifampin might be an alternative to doxycycline for patients with a severe drug allergy or who are pregnant 1.
- Treatment should begin promptly upon clinical suspicion, even before laboratory confirmation, as delayed treatment can lead to severe complications 1.
- Patients should complete the full course of antibiotics even if symptoms improve, and should be monitored for potential side effects such as photosensitivity and gastrointestinal disturbances.
It's also important to note that other antibiotics, such as beta-lactams, macrolides, aminoglycosides, and sulfonamides, are not effective against tickborne rickettsial diseases, and may even worsen the condition 1. Sulfonamide antimicrobials, in particular, are associated with increased severity of tickborne rickettsial diseases 1.
Prevention strategies, including tick checks, appropriate clothing, and repellents, should also be discussed with patients to prevent future infections. Overall, prompt treatment with doxycycline is essential for preventing severe complications and improving outcomes in patients with tick-borne diseases.
From the FDA Drug Label
Doxycycline offers substantial but not complete suppression of the asexual blood stages of Plasmodium strains.
The recommended treatment for a patient presenting with symptoms of a tick-borne disease common in Florida is doxycycline.
- Doxycycline is used to treat various bacterial infections, including those caused by ticks.
- It is essential to note that doxycycline should only be used to treat bacterial infections and not viral infections.
- Patients should be advised to take doxycycline exactly as directed and complete the full course of therapy to decrease the effectiveness of the immediate treatment and increase the likelihood that bacteria will develop resistance 2.
From the Research
Tick-Borne Diseases Common in Florida
- Tick-borne diseases in the United States include Rocky Mountain spotted fever, Lyme disease, ehrlichiosis, tularemia, babesiosis, Colorado tick fever, and relapsing fever 3
- These diseases can present with influenza-like symptoms, and a petechial rash or erythema migrans may be associated with specific diseases 3
Recommended Treatment
- Treatment with doxycycline or tetracycline is indicated for Rocky Mountain spotted fever, Lyme disease, ehrlichiosis, and relapsing fever 3, 4
- For Lyme disease, therapy depends on the age of the patient and stage of the disease, with amoxicillin or doxycycline effective for early localized disease 4, 5
- Doxycycline is the antimicrobial treatment of choice for patients with Rocky Mountain spotted fever, human monocytic ehrlichiosis, or human granulocytic ehrlichiosis 4
- A single dose of doxycycline may be effective in preventing tick-borne relapsing fever after exposure to ticks 6
Prevention and Diagnosis
- Early removal of attached ticks can help prevent disease, as 24 to 48 hours of attachment are required for infection to occur 3
- Advising patients about prevention of tick bites, especially in the summer months, may help prevent exposure to dangerous vector-borne diseases 3
- Diagnosis should not be delayed for laboratory confirmation, and treatment should be initiated based on clinical findings suggestive of tick-borne disease 3