Thompson AD. Pediatr Infect Dis J. 2012;doi:10.1097/INF.0b013e31825eb3c7.
Current Lyme meningitis treatment regimens have substantial associated morbidity, according to study results from researchers at the Nemours/Alfred I. duPont Hospital for Children in Wilmington, Del.
Amy D. Thompson, MD, and colleagues from the division of emergency conducted a retrospective cohort study of 149 children with a median age of 10 years who presented with Lyme meningitis in one of three EDs in the Lyme-endemic areas of Pennsylvania and Massachusetts between 1997 and 2010. Children were treated with parenteral antibiotics, most commonly ceftriaxone, received through a peripherally inserted central catheter (PICC).
The researchers said children often have complications related to either the PICC or the prescribed antibiotic. According to Thompson and colleagues, 26% of the 149 study participants with follow-up records had one or more complications. Adverse drug reactions occurred in 10% of patients.
They said of the 144 children who had a PICC placed, 17% had at least one PICC-associated complication; 10% had a mechanical problem; 8% had an infectious complication; and 1% had a venous thromboembolism.
“Given the high complication rates, aseptic infusion techniques, stabilization devices, and patient education should be optimized,” the researchers concluded. “Further investigation into alternate treatment regimens including a randomized clinical trial comparing oral doxycycline to parental ceftriaxone is needed.”
Disclosure: Dr. Thompson reports no relevant financial disclosures.