Doxycycline for the Treatment of Lyme Disease in Young Children.
Level 4 - case-series / case-control
Retrospective case series with parent survey and no control group.
PubMed 37820258 · doi:10.1097/INF.0000000000004128
What was done
Researchers conducted a retrospective case series of children under 8 years of age diagnosed with Lyme disease and treated with oral doxycycline. They also conducted a telephone follow-up survey with parents to evaluate clinical outcomes, treatment failures, and short-term adverse effects.
What was found
A total of 32 children were identified, of whom 18 participated in the telephone follow-up survey. Diagnoses included single erythema migrans in 69% (22/32) and neurological Lyme disease in 22% (7/32). Three patients (9%) stopped doxycycline prematurely because of adverse effects. In the telephone survey, 2 children were reported to have dental staining. No treatment failures were identified in the medical record review; 3 patients had residual symptoms at follow-up, but none were considered convincing for treatment failure.
Why it matters
This study adds real-world pediatric clinical data suggesting oral doxycycline is a well-tolerated and viable alternative for Lyme disease in children younger than 8 years old when standard options are not preferred.
Limits
The study is limited by a very small sample size (32 chart reviews, 18 survey responses), a retrospective uncontrolled design, lack of formal in-person dental examinations (relying solely on parent report for dental staining), and potential recall bias in telephone follow-up.
Cited by
- supports Doxycycline is the standard antibiotic therapy used to treat Lyme disease.