It should come as no surprise that Lyme disease is nearing pandemic levels of infection. The disorder, spread by ticks and prevalent on every continent on earth besides Antarctica, has been permitted to run riot since it was first discovered in 1975, and unchecked from long before then. It is now a global issue, on the brink of becoming an emergency. The Centers for Disease Control and Prevention in America estimate that there are 300,000 new cases of Lyme every year, though most of them either go misdiagnosed or undiagnosed. As it stands, there is a simple treatment for Lyme: antibiotics. The catch is that the medicine has to be administered in the early stages of the disease, known as the acute stage.
When the disease transitions to its chronic form, it is much more difficult to treat. Given this, there is an argument that pharmacists should be able to administer medicine for cases of suspected acute Lyme. But can you get Lyme medication over the counter? Speed is of the essence when it comes to this particular disorder, yet a good many doctors aren’t fully Lyme-literate, let alone pharmacists. To top it all off, chronic Lyme is not even a legitimate, registered disorder among many medical circles, muddying the treatment waters further.
The antibiotic used to treat cases of acute Lyme is called doxycycline prophylaxis, a common enough antibiotic that’s used to counter many infections. The Infectious Diseases Society of America recommend that the drug not be administered to patients within 36 hours of the offending tick bite, as the bacteria within the tick needs at least this amount of time to travel to travel to its salivary glands and into the host. However, this has been disputed by Lyme experts like those at BCA-clinic, who estimate that might be a highly ambitious figure, and Borrelia burgdorferi transmission (the strain of bacteria that causes Lyme) could infect the host much earlier. When even this seemingly simple piece of information has doctors at cross purposes, we seem a long way away from over-the-counter dispensation.
However, a time-sensitive solution is necessary if we are to stem the tide of Lyme. There needs to be low-barrier remedy for the thousands of patients that develop the disease every year. Over-the-counter antibiotics would, in theory, allow must patients to cut Lyme off before it even gets started, as long as they recognise the symptoms in time. There is also an argument that more people would seek treatment if there were an easier (and cheaper) solution than booking an appointment with their doctor and going through a number of potential tests. But there are some immediately obvious problems with this approach, which is why it remains a theory for now. The first is that pharmacists could get the diagnosis wrong – and in cases of suspected acute Lyme, this might be more pertinent than many people think.
The sure-fire sign of acute Lyme is a distinctive rash known as a bullseye rash. It forms around the tick bite, creating one ring encircling another red spot, hence the name. However, it doesn’t appear in 100% of cases. If this rash is not present, other acute Lyme symptoms appear very much like the typical flu: fever, chills, headaches and fatigue are all common. Thus it would potentially be quite hard for pharmacists to be completely sure of a Lyme diagnosis for every case. Bullseye rash? Yes, it’s Lyme. Fever-like symptoms with no rash? Not definitively Lyme, even if the patient recalls getting bitten by a tick. The end result is that pharmacists might end up dispensing antibiotics to those who don’t need them.
There is growing concern among the medical community that over-reliance on antibiotics can lead to resistance in the body. This argument adds fuel to that fire. The general consensus is that antibiotics should only be taken when absolutely necessary, as they can cause damage to the microbiome in the gut. Also, the final obvious problem is that pharmacists would be treating the patient for a disease they don’t have, while ignoring the one they evidently do. Despite this, treating Lyme at the acute juncture is imperative to defeating the disease and halting its spread. Chronic Lyme is not treatable solely with antibiotics, and while the infection certainly still plays a part, the body’s own immune response becomes part of the problem.
So what’s the treatment for chronic Lyme, exactly? Well, it’s a complicated process. The body’s self-initiated inflammation can sometimes be the primary symptom; if this is the case, antibiotics will have no effect. Treating chronic Lyme successfully involves a delicate balance of antibiotic therapy and nutritional therapy, to address the infection and inflammation symptoms respectively. As it stands, we are woefully underprepared to treat chronic Lyme en masse. Over-the-counter Lyme treatment would potentially be a big breakthrough in the fight against the disease, but as with most things surrounding Lyme, it requires more research, more time, and more investment of resources.