PMID- 29672671
OWN - NLM
STAT- MEDLINE
DCOM- 20191029
LR  - 20191029
IS  - 1537-6591 (Electronic)
IS  - 1058-4838 (Linking)
VI  - 67
IP  - 10
DP  - 2018 Oct 30
TI  - Adverse Events Associated With Antibiotics and Intravenous Therapies for 
      Post-Lyme Disease Syndrome in a Commercially Insured Sample.
PG  - 1568-1574
LID - 10.1093/cid/ciy329 [doi]
AB  - BACKGROUND: Non-guideline-endorsed posttreatment courses of antibiotics for 
      post-Lyme disease syndrome (PLDS) have been linked to adverse patient outcomes, 
      but these findings have yet to be validated in large systematic evaluations. 
      METHODS: A retrospective cohort analysis of medical and pharmacy claims derived 
      from the Truven Health Market Scan Commercial Claims and Encounters Database 
      assessed 90-day incidence rates of adverse events (AEs) associated with PLDS 
      treatment (PLDS-Tx). Patients were diagnosed with PLDS >/=6 months after initial 
      diagnosis and standard antibiotic treatment for Lyme disease. Comparison cohorts 
      included intravenous (IV) PLDS-Tx with or without oral antibiotics; oral 
      antibiotic-only PLDS-Tx; or neither. RESULTS: Composite AE incidence rates were 
      higher for patients treated with IV or oral PLDS-Tx than for patients not 
      receiving either treatment (18.7%, 16.8%, and 13.4%, respectively; P = .019). 
      Significant between-group differences in AE incidence rates were noted for 
      electrolyte imbalance (4.0%, 1.5%, and 0.7%, respectively; P = .001) and 
      infection (14.0%, 12.7%, and 9.3%; P = .006). Infection prevalence increased by 
      22.0% in the IV treatment group and 17.7% in the oral group. Incidence rates for 
      all-cause and AE-related hospital stays and emergency department visits were 
      higher for treated than nontreated patients, particularly when treatment was IV 
      (all P < .01). Of IV-treated patients, 7.3% experienced an incident all-cause 
      inpatient stay and 11.3% an incident all-cause emergency department visit, 
      compared with, respectively, 2.2% and 3.4% of those treated with oral antibiotics 
      and 0.9% and 1.9% of nontreated patients. CONCLUSIONS: Use of IV therapies or 
      oral antibiotics for PLDS was associated with increased patient morbidity within 
      90 days.
FAU - Goodlet, Kellie J
AU  - Goodlet KJ
AD  - Department of Pharmacy Practice, Midwestern University College of Pharmacy, 
      Glendale, Arizona.
FAU - Fairman, Kathleen A
AU  - Fairman KA
AD  - Department of Pharmacy Practice, Midwestern University College of Pharmacy, 
      Glendale, Arizona.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Clin Infect Dis
JT  - Clinical infectious diseases : an official publication of the Infectious Diseases 
      Society of America
JID - 9203213
RN  - 0 (Anti-Bacterial Agents)
SB  - IM
MH  - Anti-Bacterial Agents/*adverse effects/standards
MH  - Databases, Factual
MH  - Humans
MH  - Infusions, Intravenous/*adverse effects/standards
MH  - Length of Stay
MH  - Lyme Disease/*complications/drug therapy/epidemiology
MH  - Morbidity
MH  - Post-Lyme Disease Syndrome/*drug therapy/*epidemiology
MH  - Retrospective Studies
MH  - United States/epidemiology
EDAT- 2018/04/20 06:00
MHDA- 2019/10/30 06:00
CRDT- 2018/04/20 06:00
PHST- 2018/02/03 00:00 [received]
PHST- 2018/04/13 00:00 [accepted]
PHST- 2018/04/20 06:00 [pubmed]
PHST- 2019/10/30 06:00 [medline]
PHST- 2018/04/20 06:00 [entrez]
AID - 4972864 [pii]
AID - 10.1093/cid/ciy329 [doi]
PST - ppublish
SO  - Clin Infect Dis. 2018 Oct 30;67(10):1568-1574. doi: 10.1093/cid/ciy329.