Antibiotic prophylaxis for prevention against Lyme disease following tick bite: an updated systematic review and meta-analysis

BMC Infectious Diseases

Bingxue Li¹  Yuxin Fan¹  Yu Zhang¹  Shiqi Luo¹  Jing Kong¹  Yan Dong¹  Guozhong Zhou¹  Jingjing Chen¹  Peng Yue¹  Xin Xu¹  Meixiao Liu¹  Shiyuan Wen¹  Aihua Liu²  Fukai Bao² 

[1] The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, 650500, Kunming, China;The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, 650500, Kunming, China;Yunnan Province Key Laboratory for Tropical Infectious Diseases in Universities, Kunming Medical University, 650500, Kunming, China;

关键词: Borrelia burgdorferi;    Borreliosis;    Ixodes;    Lyme disease;    Tick bite;   

DOI  :  10.1186/s12879-021-06837-7

来源: Springer

【 摘 要 】

BackgroundIn areas where Lyme disease is endemic, bites from ticks are common, but no vaccine is currently available against Lyme disease for humans. Therefore, the feasibility of using antibiotic prophylaxis to prevent Lyme disease after a tick bite is worth further exploration. Previous meta-analyses lack sufficient power to demonstrate the efficacy of about antibiotic prophylaxis for the prevention of Lyme disease following a tick bite. In this study, we explored more precise evidence and attempted to identify and update optimum treatment strategies.MethodsWe searched PubMed, Embase, and the Cochrane Library for studies until March 23, 2021. We included studies if the enrolled patients were randomly allocated to a treatment or control group within 72 h following a tick bite and had no clinical evidence of Lyme disease at enrolment. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines were followed for data abstraction. Two authors (GZZ and XX) independently reviewed the abstracts and identified articles for detailed assessment. We used a random-effects model to calculate the pooled results and reported the 95% confidence interval (CI). Study quality was assessed using a modified Jadad scale, and publication bias was assessed using Egger’s test. We calculated the risk ratio (RR) for the rates of unfavorable events in patients who received intervention versus the control group. This study is registered with PROSPERO, number CRD42021245002.ResultsSix studies (3,766 individuals) were included. The pooled rate of unfavorable events in persons receiving treatment and the control group were 0.4% (95%CI: 0.1–1.1%) and 2.2% (95%CI: 1.6–3.0%), respectively. The pooled RR was 0.38 (95%CI: 0.22–0.66). Subgroup analysis revealed that the pooled RR was 0.29 (95%CI: 0.14–0.60) in the single-use 200-mg doxycycline group; 0.28 (95%CI: 0.05–1.67) in a 10-day course group (Amoxicillin, Penicillin or tetracycline); and 0.73 (95%CI: 0.25–2.08) in a topical antibiotic treatment group (Azithromycin).ConclusionsThe available evidence supports the use of antibiotics for the prevention of Lyme disease, and reveals advantages of using single-dose; however, further confirmation is needed.

【 授权许可】

CC BY