Diagnosis, Treatment, and Prevention of Lyme Disease, Human Granulocytic Anaplasmosis, and Babesiosis

Sanchez, Edgar H.; Vannier, Edouard; Wormser, Gary P.; Hu, Linden T.

doi:10.1001/jama.2016.2884

Cited by 268 publications

(317 citation statements)

References 125 publications

Supporting

Mentioning

299

Contrasting

Unclassified

Order By: Relevance

“…Авторы этих работ рекомендуют вы-делять заболевание, вызванное B. miyamotoi отдельно от классического ИКБ, вызываемого группой B. b. sensu lato [5,8,[17][18][19].…”

Section: клинические проявления икбunclassified

“…Процент положительных результатов ниже при использовании крови (1%-3%), ликвора (15%-20%) или внутрисуставной жидкости (20-25%). В целом, культуральный метод достаточно сложен и имеет низкую чувствительность [1,2,4,8,20].…”

Section: лабораторная диагностика икбunclassified

“…В работах J.A. Branda было показано, что использова-ние в качестве критерия положительного результата обна-ружения IgG к VlsE методом иммуноблота вместо критери-ев CDC способно увеличить чувствительность теста на ран-них стадиях ИКБ [8,26,27]. Также был разработан тест, где антигенной детерминантой выступает PepC10 -инва-риантный фрагмент антигена OspC, который так же может быть использован для ранней диагностики ИКБ [8].…”

Section: лабораторная диагностика икбunclassified

“…В биоптатах кожи (больных с МЭ или ак-родерматитами) или синовиальной жидкости (больных с Лайм-артритами) ДНК выявляется в 50-75%, чувствитель-ность выше при исследовании синовиальной жидкости. ПЦР-исследование может быть полезно для выявления недав-но открытых генотипов -B. miyamotoi и B. mayonii [2,[7][8][9].…”

Section: лабораторная диагностика икбunclassified

“…Однако диагностическая ценность этих мето-дов исследована недостаточно, и они не могут быть реко-мендованы для рутинной лабораторной диагностики [7,8,22,[29][30][31].…”

Section: лабораторная диагностика икбunclassified

See 4 more Smart Citations

Current State of Tick-Borne Borreliosis (Lyme Disease) in Children

Зверева¹,

Shakaryan²,

Sayfullin³

et al. 2017

Det. infekc.

View full text Add to dashboard Cite

Section: клинические проявления икбunclassified

Section: лабораторная диагностика икбunclassified

See 3 more Smart Citations

Current State of Tick-Borne Borreliosis (Lyme Disease) in Children

Зверева¹,

Shakaryan²,

Sayfullin³

et al. 2017

Det. infekc.

View full text Add to dashboard Cite

Improving the Physical Examination

Cayley

2016

JAMA

View full text Add to dashboard Cite

Efficacy and Safety of Antibiotic Therapy in Early Cutaneous Lyme Borreliosis

et al. 2018

View full text Add to dashboard Cite

IMPORTANCE Controversies about the choice of antibiotic agent and treatment modality exist in the management of erythema migrans in early cutaneous Lyme borreliosis (LB). OBJECTIVE To conduct a network meta-analysis (NMA) of all randomized clinical trials on various antibiotic agents and treatment modalities in early cutaneous LB. DATA SOURCES Electronic searches in MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were conducted from inception until July 2017. The reference lists of the included studies were hand searched, authors were contacted, and ongoing trials were searched at ClinicalTrials.gov. STUDY SELECTION One reviewer screened the titles and abstracts of the 9975 reports identified by the electronic searches. Full-text copies of 161 potentially relevant articles were obtained, and 2 reviewers independently assessed those articles for inclusion. Adults with a physician-confirmed early localized skin infection who were treated with antibiotics of any dose or duration were included. DATA EXTRACTION AND SYNTHESIS Two reviewers independently extracted data on study, patient, and intervention characteristics. Network meta-analyses on treatment effects and adverse outcomes were calculated with a frequentist approach using the R package netmeta. The Grading of Recommendations Assessment, Development and Evaluation guidance for NMA was used to assess the certainty of evidence. MAIN OUTCOMES AND MEASURES Treatment effects for response to treatment (resolution of symptoms) and treatment-related adverse events. RESULTS Overall, 19 studies (2532 patients) were included. The mean patient age ranged between 37 and 56 years, and the percentage of female patients ranged from 36% to 60%. The antibiotics investigated were doxycycline, cefuroxime axetil, ceftriaxone, amoxicillin, azithromycin, penicillin V, and minocycline. Pooled effect sizes from NMAs did not suggest any significant differences in treatment response by antibiotic agent (eg, amoxicillin vs doxycycline odds ratio, 1.26; 95% CI, 0.41-3.87), dose, or duration (eg, doxycycline, 200 mg/d for 3 weeks, vs doxycycline, 200 mg/d for 2 weeks, odds ratio, 1.28; 95% CI, 0.49-3.34). Treatment failures were rare at both 2 months (4%; 95% CI, 2%-5%) and 12 months (2%, 95% CI, 1%-3%) after treatment initiation. There were also no differences in the effect sizes among antibiotic agents and treatment modalities for treatment-related adverse outcomes, which were generally mild to moderate. Certainty of evidence was categorized as low and very low mostly because of imprecision, indirectness, and study limitations (high risk of bias) of the included studies. CONCLUSIONS AND RELEVANCE This NMA suggests that neither the antibiotic agent nor treatment modality contributed to comparative effectiveness or drug-related adverse outcomes. This finding is relevant for physicians treating patients with LB and for patient decision making.

show abstract

Diagnosis, Treatment, and Prevention of Lyme Disease, Human Granulocytic Anaplasmosis, and Babesiosis

Cited by 268 publications

References 125 publications

Current State of Tick-Borne Borreliosis (Lyme Disease) in Children

Current State of Tick-Borne Borreliosis (Lyme Disease) in Children

Improving the Physical Examination

Efficacy and Safety of Antibiotic Therapy in Early Cutaneous Lyme Borreliosis

Contact Info

Product

Resources

About