Original Research
Monday, October 14, 2024
01:00 PM–02:30 PM
Abstract
Introduction: Lyme carditis is a cardiovascular complication of early disseminated Lyme disease. Although clinical practice guidelines recommend treatment with intravenous ceftriaxone followed by oral doxycycline with clinical improvement, limited data support this recommendation. This study evaluated clinical outcomes following management of Lyme carditis.
Research Question or Hypothesis: What patient outcomes are observed following treatment of hospitalized patients with Lyme carditis?
Study Design: Retrospective cohort study (January 2016-May 2024)
Methods: Adult patients with a Lyme carditis diagnosis admitted within a large hospital network were included. Outpatients, patients treated at an external hospital, and patients without antibiotic therapy were excluded. Electronic health record review included demographic, laboratory, and Suspicious Index in Lyme Carditis (SILC) score data. The primary outcome was 30-day readmission for Lyme carditis. Secondary outcomes included length of stay (LOS), cardiovascular endpoints, and 30- or 90-day mortality. Data was analyzed using descriptive statistics in Microsoft Excel (Redmond, WA).
Results: Sixty-two patients were included: 80.6% male and 93.5% white with a mean (± SD) age of 50.0 (± 19.3) years. Admissions were most common in July (18; 29.0%) with a mean 4.8 (± 4.5) days LOS, and approximately half of the patients had an intensive care unit stay. Fifteen (24.2%) patients received ceftriaxone alone for a mean 24.2 (± 8.1) days of therapy (DOT), while 42 (67.7%) received a mean 5.6 ceftriaxone DOT prior to doxycycline for a total of 24.4 (± 6.5) DOT. SILC scores were commonly intermediate (29; 46.8%) or high (27; 43.5%) suspicion category. Fifty-seven (91.9%) patients experienced heart block. Eighteen (29.0%) patients required temporary pacing, and 10 (16.1%) required a permanent pacemaker. A 14.5% mean reduction in PR interval was observed from presentation to discharge. Three (4.8%) patients were readmitted for Lyme carditis symptoms within 30 days. No 30- or 90-day mortality was observed.
Conclusion: Various Lyme carditis antibiotic regimens in this study demonstrated low readmission rates.
Presenting Author
Alexandra L Gordon PharmD Candidate 2025Duquesne University
Authors
Jordan R Covvey PharmD, PhD, BCPS
Duquesne University
Jude M Gdula PharmD Candidate 2025
Duquesne University
Anthony J Guarascio PharmD, BCPS
Allegheny General Hospital
Nicholas J Kolano PharmD Candidate 2025
Duquesne University
Courtney A Montepara PharmD, BCCP
Duquesne University
Branden D Nemecek PharmD, BCPS
Duquesne University
David E Zimmerman PharmD, BCPS, BCCCP
Duquesne University