USMLE · Question #620
A 65-year-old female with end stage renal failure comes to her physician with a rash and is diagnosed with Lyme disease. Review of her medical records reveals severe allergic reactions to penicillin…
The correct answer is B. doxycycline. Tetracyclines such as doxycycline are antibiotics commonly used to treat infections such as Rocky Mountain spotted fever, typhus and Lyme disease, which are all caused by spirochetes. They are also used for the treatment of acne, sexually transmitted diseases and for…
Question
A 65-year-old female with end stage renal failure comes to her physician with a rash and is diagnosed with Lyme disease. Review of her medical records reveals severe allergic reactions to penicillin and macrolides. The most appropriate treatment for this patient's current disease is
Options
- Ademeclocycline
- Bdoxycycline
- Cmetronidazole
- Doxytetracycline
- Etetracycline
How the community answered
(26 responses)- A12% (3)
- B77% (20)
- D8% (2)
- E4% (1)
Explanation
Tetracyclines such as doxycycline are antibiotics commonly used to treat infections such as Rocky Mountain spotted fever, typhus and Lyme disease, which are all caused by spirochetes. They are also used for the treatment of acne, sexually transmitted diseases and for susceptible organisms in patients who are allergic to penicillin. The treatments for Lyme disease without neurologic symptoms or heart block include doxycycline and amoxicillin. Doxycycline and minocycline are tetracyclines excreted largely by routes other than the kidneys. They are secreted in an inactive form into the intestinal lumen and eliminated in the feces. The other tetracyclines listed are concentrated by the liver in the bile and excreted in the urine and feces unchanged hence, they are not the best treatment option in this patient with renal failure. Metronidazole is not used to treat Lyme disease.
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