Excerpted from Providence Journal: (07/29/2017)
Program allows S. Kingst wn pharmacy to offer drug for tick bites meeting strict criteria: It must be a deer tick of a certain size found within 72 hours of the bite
SOUTH KINGSTOWN — A family-owned pharmacy in this seaside town recently began dispensing antibiotics to people without prescriptions to reduce the risk of developing Lyme disease.
Green Line Apothecary announced in late June that it is offering the single 200-mg prophylactic dose of doxycycline to adults within 72 hours of a deer tick bite if they meet the U.S. Centers for Disease Control and Prevention’s criteria for infection risk.
Proponents of the program — reportedly the first of its kind in the country — say it serves an important public health need by expanding timely access to treatment that could prevent more people from developing the potentially debilitating disease. And they hope it will become a national model.
But experts caution that expanding access to antibiotics to prevent Lyme disease may do more harm than good. Most people who will get the preventative treatment, they say, would likely never have developed Lyme disease. For those who are infected, some doctors worry a prophylactic dose may not be enough to prevent the patient from getting sick. And misuse or overuse of antibiotics can contribute to another major public health problem: antibiotic resistance.
The pharmacy program follows passage of legislation by the Rhode Island General Assembly in 2016 that expands pharmacists’ role to include initiation of drug therapies under so-called collaborative practice agreements.
The state health department’s approval of the Green Line program comes amid growing public concern over Lyme disease, which each year is diagnosed in roughly 30,000 people in the country, 95 percent of them in 14 states including Rhode Island, according to the U.S. Centers for Disease Control and Prevention.
In 2015, Rhode Island reported 904 diagnosed cases of Lyme disease, the 11th-highest rate in the country, according to the CDC.
“As a state we are always looking at ways to be proactive in reducing the incidence of Lyme disease,″ said Dr. Nicole Alexander-Scott, the state health director who, on June 12, signed a two-year collaborative practice agreement with Green Line. The pharmacy program, she said, is “one of those approaches.”
Washington County is Rhode Island’s ground zero for Lyme disease, with nearly twice the statewide rate, state health data show.
“Everybody knows someone who has been impacted by Lyme,” said Anita N. Jacobson, a pharmacist and clinical associate professor at the University of Rhode Island College of Pharmacy.
Christina Procaccianti, a pharmacist and Green Line’s owner, is one of those people. The vintage-style pharmacy and soda fountain opened in 2016 on Main Street in Wakefield.
Procaccianti, 34, contracted Lyme disease in 2011, while she was pregnant. After an eight-week course of antibiotics, she said, she made a full recovery and delivered a healthy baby girl. “I know how awful Lyme is,”
she said.“If we can prevent it for anybody,” she said, the effort will be a success.
Lyme Handbook 