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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Är behandling med doxycyklin motiverat vid borreliainfektion?

Wööras, Daniel January 2015 (has links)
Background: Every year approximately 5 000-10 000 persons in Sweden are diagnosed for Lyme disease. In Europe the incidence is about 65 000 persons per year. Lyme disease is a tick-borne zoonosis, the causative agents – Borrelia burgdorferi-genospecies - are transmitted by Ixodes-ticks (in Sweden primary I.ricinus). Lyme disease is treated with antibiotic-therapy. Though, in 5-15 percent of the cases, post-treatment symptoms can appear and persist for six months, or longer. Today we don´t know the origin of the phenomena. Some patients seek help outside the Swedish borders, and turn to so called Lyme disease-clinics – which, in some cases, institutes long-term antibiotic-treatment. The pharmacist may encounter this particular matter, while carrying out EES-antibiotic-prescriptions, prescribed non-analogous to Swedish guidelines.  Objective: The aim of this study was to investigate the efficacy of doxycycline, with respect to short-, middle-, and long-term Lyme disease-treatment. The intention was also to investigate the pharmacist role in executing EES-antibiotic-prescriptions.  Methods: The study was divided into two parts. The first part was investigating doxycycline, and was based on five scientific articles collected from PubMed. The second part was a review of the pharmacist role in processing EES-antibiotic-prescriptions; information was collected by email correspondence with pharmacy chain stores, authorities and federation of labor unions.  Results: Awareness and protective measures regarding ticks and Lyme disease seems dire. Improved diagnostic methods, uniform interpretation of outcome, standardized laboratory-analysis is of paramount importance. The pharmacist concerns with EES-antibiotic-prescriptions is carrying out the medical prescription and giving medical advice. Doxycycline in 10-14 days Lyme disease-treatment was seen as an alternative, supported by Swedish guidelines. The post-exposure prophylaxis was not a recommended alternative. Regarding doxycycline and long-term Lyme-disease-treatment, it was postulated that additional scientific studies was needed. Conclusions: The tick, vector of Borrelia burgdorferi, will be favoured of recent and upcoming climate changes. In the future to come, we can expect an expansion of the tick-habitats and with it follows the probability of more frequent encounters with the human race. This will most likely contribute to a higher incidence of Lyme disease. Prevention and subject-enlightenment is of need. The pharmacist will in the professional role be exposed to daily moral dilemmas; one of these dilemmas can be the execution of EES-antibiotic-prescriptions, not prescribed accordingly to Swedish guidelines, with respect to Lyme disease. As things stand today, the primary commitment will be medical advice and carrying out the prescription. The post-exposure prophylaxis regarding doxycycline and Lyme disease is not recommended. The 10-14 days doxycycline-cure, regarding some Lyme disease-manifestations, is mostly a preferable alternative today. Prolonged antibiotic-treatment with doxycycline, in respect to post-treatment symptoms, needs to be further evaluated with better diagnostic methods, scientific studies, standardized analysis and more uniform interpretation of results.

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