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A single dose of doxycycline can serve as effective post-exposure prophylaxis for Lyme disease following a high-risk tick bite. Despite historical concerns about doxycycline toxicity in children under eight years of age, recent guidelines state that treatment courses of less than 21 days are safe for children of any age.
To build upon earlier research focused primarily on adults, the Centers for Disease Control and Prevention (CDC) collaborated with the U.S. Food and Drug Administration (FDA) to leverage the Sentinel System's comprehensive data, including commercial insurance and Medicaid claims, to provide new insights into doxycycline dispensing for both adult and pediatric populations.
The study aimed to characterize the patterns of single-dose doxycycline dispensing by:
- Describing state-level trends in pediatric and adult prescription claims.
- Examining patient-level factors such as age, sex, race, ethnicity, and urbanization in pediatric and adult prescription claims.
- Quantifying how many pediatric and adult patients received multiple courses of single-dose doxycycline.
- Comparing dispensing trends in pediatrics between Medicaid and commercial insurance.
Results indicated dispensing patterns of single-dose doxycycline in both adults and children closely aligned with known Lyme disease epidemiology, showing higher rates in the Northeast and Mid-Atlantic regions and seasonal peaks in spring, summer, and fall. Importantly, the findings also suggested that Lyme disease post-exposure prophylaxis may be underutilized in the pediatric population, particularly among children covered by Medicaid.
The findings from the Sentinel analyses supported CDC’s ongoing Lyme disease surveillance efforts and contributed important insights that build on CDC’s previous work by providing valuable data on post-exposure prophylaxis use among the pediatric population.