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Correspondence
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Volume 328:1418-1420 May 13, 1993 Number 19
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Antimicrobial Prophylaxis after Tick Bites

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To the Editor: We believe Shapiro et al. (Dec. 17 issue)1 had inadequate evidence to support their recommendation for nontreatment of deer-tick bites. The population samples were much too small for a meaningful comparison of the risks of serious late sequelae with the risks and benefits of prophylactic antibiotic therapy.

Consider the hypothetical situation of 10,000 deer-tick bites in Connecticut, in which 120 people would acquire the disease and 15 to 36 would not manifest erythema migrans. Magid et al.2 estimate that 60 percent of these people would acquire chronic arthritis, 17 percent meningoencephalitis or neuropathy, and 6 percent cardiac . . . [Full Text of this Article]

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