Topical azithromycin for the prevention of Lyme borreliosis: a randomised, placebo-controlled, phase 3 efficacy trial

Schwameis, Michael; Kündig, Thomas M.; Huber, Gustave; Bidder, Luzi von; Meinel, Lorenz; Weisser, Roland; Aberer, Elisabeth; Härter, Georg; Weinke, Thomas; Jelı́nek, Tomáš; Fätkenheuer, Gerd; Wollina, Uwe; Burchard, Gerd‐Dieter; Aschoff, Roland; Nischik, Ruth; Sattler, Gerhard; Popp, Georg; Lotte, Wolfgang; Wiechert, Dirk; Eder, Gerald; Maus, Olga; Staubach‐Renz, Petra; Grafe, Andrea; Geigenberger, Veronika; Naudts, Ingomar; Sebastian, Michael; Reider, Norbert; Weber, R; Heckmann, Marc; Reisinger, Emil C.; Klein, Georg; Wantzen, Johannes; Jilma, Bernd

doi:10.1016/s1473-3099(16)30529-1

Cited by 25 publications

(26 citation statements)

References 24 publications

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“…4 Early manifestations include nonspecific signs and symptoms such as headache, fever and myalgias. 10 The disease typically commences with an erythematous rash known as erythema migrans (EM), 4,25 due to local skin infection which is observed in between 60-80% of infected people several days to weeks after the tick bite. 10,11 The EM rash expands by 2-3cm per day over several days with some parts clearing to result in a bulls eye image.…”

Section: History Of the Diseasementioning

confidence: 99%

“…10 The disease typically commences with an erythematous rash known as erythema migrans (EM), 4,25 due to local skin infection which is observed in between 60-80% of infected people several days to weeks after the tick bite. 10,11 The EM rash expands by 2-3cm per day over several days with some parts clearing to result in a bulls eye image. 10 Diagnosis of Lyme borreliosis is based on patient history of potential exposure to ticks, infection risk with B. burgdorferi sensu lato, the EM rash and development of specific symptoms, exclusion of other causes and appropriate serological or other diagnostic tests indicating a positive a positive Borrelia serology.…”

Section: History Of the Diseasementioning

confidence: 99%

“…10,11 The EM rash expands by 2-3cm per day over several days with some parts clearing to result in a bulls eye image. 10 Diagnosis of Lyme borreliosis is based on patient history of potential exposure to ticks, infection risk with B. burgdorferi sensu lato, the EM rash and development of specific symptoms, exclusion of other causes and appropriate serological or other diagnostic tests indicating a positive a positive Borrelia serology. 6,7,26 Epidemiologic context is extremely important, with the probability of a tick bite (likelihood of contracting Lyme disease) highest in individuals who spend time outdoors (particularly in wooded, brushy, or grassy habitats) in a geographically endemic area, and at certain times of year.…”

Section: History Of the Diseasementioning

confidence: 99%

“…4 Geographic distribution and incidence of Lyme disease is on the increase worldwide, and has become the most common vector-borne illness in Europe particularly Austria, Czech Republic, Germany, Slovenia, and Switzerland; and in China, Australia, Africa and North East United States (US). 2,5,6,7,8,9,10,11 Lyme disease or Lyme Borreliosis is caused by spirochaetes of the B burgdorferi sensu lato o species complex and is transmitted by infected Ixodes scapularis or Ixodes ricinus ticks. 5,6,7,10,11 In 2000, Rowe reported that Lyme disease in Europe is caused by any one of three tick borne spirochetes in the B. burgdorferi sensu lato complex-B burgdorferi sensu stricto, B afzelii, and B garinii, whereas in the US, only the first species is involved.…”

Section: Introductionmentioning

confidence: 99%

“…11 Prevention strategies centre on use of insect repellents, application of pesticides and removal of ticks, with no pharmacological prevention strategy available. 10…”

Section: Introductionmentioning

confidence: 99%

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The Controversies, Challenges and Complexities of Lyme Disease: A Narrative Review

Hout

2018

J Pharm Pharm Sci

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Purpose: Lyme disease has become an increasingly important global public health concern. Method: A narrative review was conducted and designed to present a broad perspective on Lyme disease, and describe its history and development in terms of clinical care and public health implications. A structured literature search was conducted based on the question; what is currently known about Lyme disease? Results: The narrative review is presented in chronological order in terms of a summary of the history of Lyme disease, the complexities of clinical diagnosis, the problematic interpretation of serologic testing, the conflicting guidelines for diagnosis, treatment and management of chronic Lyme, and benefits of antibiotic treatment. Conclusion: Despite growing global incidence of the Lyme disease, treatment has not attracted pharmaceutical investment, and the evidence base and international guidelines for treatment and management of chronic Lyme continue to be conflicting and controversial. The challenges of this immune mediated tick borne disease for public health policy and clinical practice are summarised, alongside directions for future research.

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Section: History Of the Diseasementioning

confidence: 99%

Section: History Of the Diseasementioning

confidence: 99%

Section: History Of the Diseasementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…11 Prevention strategies centre on use of insect repellents, application of pesticides and removal of ticks, with no pharmacological prevention strategy available. 10…”

Section: Introductionmentioning

confidence: 99%

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