Antibiotic use and treatment-associated adverse events among children with and without ARLA.
| Treatment Characteristics | Resolved < 3 Mos, n = 188 | ARLA, n = 49 | p1 |
|---|---|---|---|
| Antibiotics | |||
| Oral antibiotics | 185 (98) | 49 (100) | 0.992 |
| Amoxicillin | 109 (58) | 24 (49) | 0.26 |
| Doxycycline | 91 (48) | 43 (88) | < 0.001 |
| Cefuroxime | 8 (4) | 6 (12) | 0.052 |
| Other | 2 (1) | 0 | 0.992 |
| Days of oral antibiotics, median (IQR) | 28 (28–30) | 57 (56–72) | < 0.0013 |
| IV antibiotics | 13 (7) | 28 (57) | < 0.001 |
| Ceftriaxone | 13 (7) | 28 (57) | < 0.001 |
| Days of IV antibiotics, median (IQR)4 | 28 (21–28) | 28 (21–28) | 0.303 |
| Total days of antibiotics, median (IQR) | 30 (28–35) | 76 (58–88) | < 0.0013 |
| Prescribed NSAID | 57 (30) | 39 (80) | < 0.001 |
| Adverse events during antibiotic treatment period | |||
| Any recorded treatment-associated adverse event5 | 29 (15) | 18 (37) | 0.001 |
| Fever | 3 (2) | 2 (4) | 0.282 |
| Rash | 8 (4) | 9 (18) | 0.0022 |
| Non-rash allergic reactions | 0 | 2 (4) | 0.042 |
| Heartburn | 1 (1) | 2 (4) | 0.112 |
| Abdominal pain | 7 (4) | 3 (6) | 0.442 |
| Vomiting | 8 (4) | 3 (6) | 0.702 |
| Diarrhea | 5 (3) | 0 | 0.592 |
| Headache | 2 (1) | 4 (8) | 0.022 |
| Dizziness | 1 (1) | 0 | 0.992 |
| Altered mental status | 0 | 1 (2) | 0.212 |
| Clostridium difficile or other infection | 0 | 0 | – |
| Thrombosis | 0 | 0 | – |
| Mechanical IV problem | 0 | 2 (4) | 0.042 |
| Hospitalization for any treatment-associated adverse event6 | 1 (1) | 3 (6) | 0.032 |
Values are expressed as n (%) unless otherwise indicated.
↵1 Calculated from chi-square test except where indicated.
↵2 Calculated from Fisher’s exact test.
↵3 Calculated from Wilcoxon rank-sum test.
↵4 Calculated among subjects who received ceftriaxone.
↵5 Some subjects had > 1 adverse event.
↵6 Excluding hospitalization for worsening disease (e.g., leg swelling from popliteal cyst rupture). ARLA: antibiotic-refractory Lyme arthritis; IQR: interquartile range; IV: intravenous; NSAID: nonsteroidal antiinflammatory drugs.