Self-Reported Treatment Practices by Healthcare Providers Could Lead to Death from Rocky Mountain Spotted Fever

Published:November 18, 2013DOI:https://doi.org/10.1016/j.jpeds.2013.10.008
      Among 2012 Docstyle survey respondents, 80% identified doxycycline as the appropriate treatment for Rocky Mountain spotted fever in patients ≥8 years old, but only 35% correctly chose doxycycline in patients <8 years old. These findings raise concerns about the higher pediatric case-fatality rate of Rocky Mountain spotted fever observed nationally. Targeted education efforts are needed.
      CME ( Continuing medical education), HCP ( Healthcare provider), RMSF ( Rocky Mountain spotted fever)

      References

        • Dahlgren F.S.
        • Holman R.C.
        • Paddock C.D.
        • Callinan L.S.
        • McQuiston J.H.
        Fatal rocky mountain spotted Fever in the United States, 1999-2007.
        Am J Tropical Med Hygiene. 2012; 86: 713-719
        • Openshaw J.J.
        • Swerdlow D.L.
        • Krebs J.W.
        • Holman R.C.
        • Mandel E.
        • Harvey A.
        • et al.
        Rocky Mountain spotted fever in the United States, 2000-2007: interpreting contemporary increases in incidence.
        Am J Tropical Med Hygiene. 2010; 83: 174-182
        • Kirkland K.B.
        • Wilkinson W.E.
        • Sexton D.J.
        Therapeutic delay and mortality in cases of Rocky Mountain spotted fever.
        Clinical Infect Dis. 1995; 20: 1118-1121
        • Holman R.C.
        • Paddock C.D.
        • Curns A.T.
        • Krebs J.W.
        • McQuiston J.H.
        • Childs J.E.
        Analysis of risk factors for fatal Rocky Mountain spotted fever: evidence for superiority of tetracyclines for therapy.
        J Infect Dis. 2001; 184: 1437-1444
        • Chapman A.S.
        • Bakken J.S.
        • Folk S.M.
        • Paddock C.D.
        • Bloch K.C.
        • Krusell A.
        • et al.
        Diagnosis and management of tickborne rickettsial diseases: Rocky Mountain spotted fever, ehrlichioses, and anaplasmosis—United States: a practical guide for physicians and other health-care and public health professionals.
        MMWR recommendations and reports: morbidity and mortality weekly report. Recommendations and reports/Centers for Disease Control. 2006; 55: 1-27
      1. Rocky Mountain spotted fever. American Academy of Pediatrics, Elk Grove Village, IL2009
        • Mosites E.
        • Carpenter L.R.
        • McElroy K.
        • Lancaster M.J.
        • Ngo T.H.
        • McQuiston J.
        • et al.
        Knowledge, attitudes, and practices regarding Rocky Mountain spotted fever among healthcare providers, Tennessee, 2009.
        Am J Tropical Med Hygiene. 2013; 88: 162-166
        • Sloan B.
        • Scheinfeld N.
        The use and safety of doxycycline hyclate and other second-generation tetracyclines.
        Expert Opin Drug Safety. 2008; 7: 571-577
        • Volovitz B.
        • Shkap R.
        • Amir J.
        • Calderon S.
        • Varsano I.
        • Nussinovitch M.
        Absence of tooth staining with doxycycline treatment in young children.
        Clin Pediatr. 2007; 46: 121-126
      2. Vibramycin [Package Insert]. In: Labs P, editor. New York, NY2007.