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August 2006 Literature Review Postexposure Treatment with Doxycycline for the Prevention of Tick-Borne Relapsing Fever This is a report from Israel in which a double-blind, placebo-controlled trial was done in 93 healthy adults with suspected exposure to Tick-borne relapsing fever (TBRF) based on signs of tick bites or close contact. The prophylactic regimen used was doxycycline, 200 mg immediately and then 100 mg/day for four days. The results showed TBRF in ten of 46 patients in the placebo group compared to none of 47 who received doxycycline. These data are summarized in the following table:
The authors conclude that doxycycline is safe and effective in preventing TBRF. Comment: TBRF is an acute febrile illness characterized by remissions and relapses. The putative agent is Borrelia persica which is transmitted by ticks. The rate of transmission from a tick bite is 50%, the incubation period is 2-18 days, and the Borrelia is found in the blood during febrile periods. The gold standard for diagnosis is to observe the spirochete on blood smear, but additional diagnostic methods include PCR or serology. The study summarized here shows the benefit of doxycycline prophylaxis which is not dissimilar to the experience with tick-borne Lyme disease. Literature Review by John G. Barlett, M.D. Professor, Division of Infectious Diseases |
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