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Thursday, October 31, 2013

Efficacy of azithromycin cream for prophylaxis of Lyme

I thought this was interesting. I had actually thought about this over the years, because of the shape of the bull's-eye rash. I assume that because Lyme spirochetes can live in the skin, that the rash is just the result of the spirochetes invading the skin and disseminating outward, which would create a circular shape.  (Bold emphasis below, added.). -Bob

Efficacy of an experimental azithromycin cream for prophylaxis of tick-transmitted Lyme disease spirochete infection in a murine model.

Joseph Piesman, Andrias Hojgaard, Amy J. Ullmann and Marc C. Dolan
Antimicrobial Agents and Chemotherapy, online ahead of print 28 October 2013.

http://doi.org/10.1128/AAC.01932-13

Abstract

As an alternative to oral prophylaxis for the prevention of tick transmission of Borrelia burgdorferi, we tested antibiotic cream prophylactic formulations in a murine model of spirochete infection. A 4% preparation of doxycycline cream afforded no protection, but a single application of 4% azithromycin cream was 100% protective when applied directly to the tick bite site at the time of tick removal.

Indeed, the azithromycin cream was 100% effective when applied up to 3 days after tick removal and protected 74% of mice exposed to tick bite when applied up to 2 weeks after tick removal. Azithromycin cream was also protective when applied at a site distal to the tick-bite-site, suggesting it was having a systemic effect in addition to a local transdermal effect. Mice that were protected from tick-transmitted infection did not seroconvert and did not infect larval ticks on xenodiagnosis.

Azithromycin cream formulations appear to hold promise for Lyme disease prophylaxis.

http://doi.org/10.1128/AAC.01932-13

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