ANTIMICROBIAL PROPHYLAXIS (AMP)
4 RCTs (USA)
- NEJM 1992;327:1769. (double-blind, 387 pts, 1y. follow-up)
- 344 deer ticks analyzed, 15% infected
- Risk of infection in placebo group: 1,2% vs 0 in amoxi. (NS)
- NEJM 2001;345:79 : (double-blind, 482 pts, 6 weeks follow up)
- risk of infection 3,2% placebo vs 0,4% doxy 1 dose 200 mg ? > 72h, I. scapularis at nymphal stage, engorged tick.
1 meta-analysis (96)
- 600 adults and children, follow-up 6m-3y.
- Peni/ampi/tetra (10d) vs placebo
- Pooled rate of infection in placebo 1,4% vs 0% (NS)
- Low incidence of reported events : the addition of 1 event could influence the results.
- Risk of AB related adverse events > cases of early LD prevented, not cost-effective.