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The Truth About Ticks and Prophylactic Antibiotics

With the blossoming of the spring flowers comes another, less savory, aspect of warm weather:  Ticks!  New England, and Vermont especially, has become synonymous with the words “Lyme Disease”.  Originally described as “Lyme Arthritis” in 1977, Lyme Disease was discovered when a cluster of children in Lyme, Connecticut came down with a constellation of symptoms including a rash, joint pain, fatigue, and low-grade fevers.  We now know that Lyme Disease has spread well beyond Lyme, Connecticut.  It is an infection caused by the spirochete Borrelia burgdorferi.

Finding a tick can be a frightening experience for many.  The creepy-crawly factor aside, the fear of contracting Lyme Disease is a real concern for many Vermonters.  The good news is that just because you have a tick on you (or even in you), does not mean you are automatically going to contract Lyme Disease.  In fact, the Centers for Disease Control (CDC) has a very strict set of guidelines on who needs antibiotic treatment after a tick bite. 

If you have been bitten by a tick, I highly recommend you come on into one of our ClearChoiceMD Urgent Care Centers.  All our providers are trained in tick removal, assessment, and management and we follow evidence based practice guidelines for antibiotic prophylaxis.  When you come in, we’ll often ask to see the tick (if you already removed it), because identification of the bug as a deer tick (as opposed to a dog tick, for example) increases your risk of Lyme Disease.  If the tick is still attached, we will carefully remove it in the office.  The entire procedure takes less than a few minutes and is relatively painless so even if you are squeamish, we can take care of you.  But, what about antibiotics after a tick bite?  Do you really need them?  According to the CDC, patients only qualify for prophylactic antibiotic treatment with a single dose of doxycycline IF they meet all of the following criteria:

  • Attached tick is identified as an adult or nymphal deer tick (Ixodes scapularis).
  • Tick is estimated to have been attached for > 36 hours.
  • Antibiotic is started within < 72 hours of tick removal.
  • Local rate of infection of ticks with Borrelia burgdorferi is > 20%.
  • There are no medical reasons that prevent you from taking the antibiotic (doxycycline).

If you do not meet all those requirements, the CDC does NOT recommend starting you on an antibiotic.  ClearChoiceMD providers are dedicated to not only evaluating and treating patients, but we are also dedicated to educating them.  When you come into one of our clinics we will give you and your family the best care possible and this means taking the time to explain what we are doing and why.  It is easy to write a prescription for an antibiotic and send a patient on their way but that doesn’t mean it’s the right intervention medically.  The truth is we will take care of you and your family based on your specific needs and presentation.  You might not need an antibiotic, but if you do we are here for you.

Written by Kateland Kelly PA-C, Saint Albans, VT