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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Empiric antibiotic treatment of erythema migrans-like skin lesions as a function of geography: A clinical and cost effectiveness modeling study
Vector-Borne and Zoonotic Diseases, Volume 13, No. 12, Year 2013
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Description
The skin lesion of early Lyme disease, erythema migrans (EM), is so characteristic that routine practice is to treat all such patients with antibiotics. Because other skin lesions may resemble EM, it is not known whether presumptive treatment of EM is appropriate in regions where Lyme disease is rare. We constructed a decision model to compare the cost and clinical effectiveness of three strategies for the management of EM: Treat All, Observe, and Serology as a function of the probability that an EM-like lesion is Lyme disease. Treat All was found to be the preferred strategy in regions that are endemic for Lyme disease. Where Lyme disease is rare, Observe is the preferred strategy, as presumptive treatment would be expected to produce excessive harm and increased costs. Where Lyme disease is rare, clinicians and public health officials should consider observing patients with EM-like lesions who lack travel to Lyme disease-endemic areas. © 2013 Mary Ann Liebert, Inc.
Authors & Co-Authors
Lantos, Paul Michael
United States, Durham
Duke University School of Medicine
Brinkerhoff, Robert Jory
United States, Richmond
University of Richmond
South Africa, Durban
University of Kwazulu-natal
Wormser, Gary P.
United States, Valhalla
New York Medical College
Clemen, Robert T.
United States, Durham
Fuqua School of Business
Statistics
Citations: 20
Authors: 4
Affiliations: 5
Identifiers
Doi:
10.1089/vbz.2013.1365
ISSN:
15303667
e-ISSN:
15577759