25244410

PMC4652931

Objective

In a recent national survey, over 30% of healthcare providers (HCPs) reported prescribing tick bite prophylaxis in the previous year. To clarify provider practices, we surveyed HCPs to determine how frequently and for what reasons they prescribed tick bite prophylaxis.

Methods

We included four questions regarding tick bite prophylaxis in the DocStyles 2012 survey, a computer-administered questionnaire of 2205 U.S. primary care physicians, pediatricians, and nurse practitioners. Responses in 14 states with high Lyme disease incidence (high-LDI) were compared with responses from other states (low-LDI).

Results

Overall, 56.4% of 1485 providers reported prescribing tick bite prophylaxis at least once in the previous year, including 73.9% of HCPs in high-LDI and 48.2% in low-LDI states. The reasons given were “to prevent Lyme disease” (76.9%); “patients request it” (40.4%); and “to prevent other tickborne diseases” (29.4%). Among HCPs who provided prophylaxis, 45.2% did so despite feeling that it was not indicated. Given a hypothetical scenario involving a patient with an attached tick, 38.1% of HCPs from high-LDI states and 15.1% from low-LDI states would prescribe a single dose of doxycycline; 19.0% from high-LDI states and 27.5% from low-LDI states would prescribe a full course of doxycycline.

Conclusions

HCPs prescribe tick bite prophylaxis frequently in areas where Lyme disease is rare and for tickborne diseases for which it has not been shown effective. HCPs may be unaware of current tick bite prophylaxis guidelines or find them difficult to implement. More information is needed regarding the efficacy of tick bite prophylaxis for diseases other than Lyme disease.

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