Bloch Joakim, Schmidt Lisbeth, Vissing Nadja, Glenthøj Jonathan Peter, Smith Birgitte, Born Alfred Peter, Poulsen Anja, Lebech Anne-Mette, Nygaard Ulrikka
Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
Department of Clinical Medicine, Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark.
Acta Paediatr. 2025 Aug;114(8):2061-2065. doi: 10.1111/apa.70085. Epub 2025 Apr 5.
There is limited evidence on the use of oral doxycycline in young children. We evaluated the feasibility and effectiveness of doxycycline in children under 9 years with neuroborreliosis.
This retrospective study included all children under 9 years of age treated for neuroborreliosis in the Capital Region of Denmark from 2019 to 2023. Patients were identified through Borrelia burgdorferi antibody tests and International Classification of Disease, 10th revision codes. Outcomes were change of treatment route, intolerable adverse effects of oral doxycycline, progression of symptoms after treatment cessation, continuous symptoms of neuroborreliosis exceeding 6 months, and relapse of neuroborreliosis.
Of 116 children, 63 (54%) received doxycycline initially, 4 (6%) of whom switched to intravenous treatment due to adverse effects or symptom worsening during treatment. Of 46 (40%) receiving intravenous antibiotics followed by doxycycline, 45 (98%) completed the remaining treatment on doxycycline. Seven (6%) patients received intravenous antibiotics only. Of 109 patients receiving doxycycline, two (2%) experienced photosensitivity rash. Symptoms lasting over 6 months were observed in two patients. No patients had symptom progression or relapse during the follow-up period (median 41 months, range 12-66).
Oral doxycycline was effective and feasible in children under 9 years with neuroborreliosis.
关于幼儿使用口服多西环素的证据有限。我们评估了多西环素在9岁以下神经型莱姆病患儿中的可行性和有效性。
这项回顾性研究纳入了2019年至2023年在丹麦首都地区接受神经型莱姆病治疗的所有9岁以下儿童。通过伯氏疏螺旋体抗体检测和国际疾病分类第10版编码来确定患者。结局指标包括治疗途径的改变、口服多西环素无法耐受的不良反应、停药后症状的进展、神经型莱姆病持续症状超过6个月以及神经型莱姆病复发。
116名儿童中，63名（54%）最初接受了多西环素治疗，其中4名（6%）因治疗期间出现不良反应或症状恶化而改为静脉治疗。在46名（40%）先接受静脉抗生素治疗后再接受多西环素治疗的儿童中，45名（98%）完成了多西环素的剩余治疗。7名（6%）患者仅接受了静脉抗生素治疗。在109名接受多西环素治疗的患者中，2名（2%）出现了光敏性皮疹。有两名患者出现了持续超过6个月的症状。在随访期间（中位时间41个月，范围12 - 66个月），没有患者出现症状进展或复发。
口服多西环素在9岁以下神经型莱姆病患儿中有效且可行。
