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Black patients have significantly longer median time to appropriate antibiotic treatment than Whites

Black patients are more likely to be diagnosed with disseminated manifestations of Lyme disease (LD) and experience longer time to appropriate treatment, according to a research letter published online Dec. 12 in JAMA Network Open.

Samuel J. Starke, M.D., from the Johns Hopkins University School of Medicine in Baltimore, and colleagues conducted a cross-sectional study to analyze data from patients with suspected untreated or posttreatment LD. Initial LD presentations were classified as erythema migrans (EM) only; disseminated neurologic, cardiac, or joint disease; or symptoms only, without objective signs. Racial distributions were examined across groups.

The final sample included 1,395 patients; differences were most marked among Black patients, and subsequent analyses compared 1,334 Black and White patients. The researchers found that Black patients had 4.93 times the odds of disseminated disease compared with the EM-only group, after controlling for age and gender. Men also had higher odds of disseminated disease (odds ratio, 1.61). The odds of being in the symptoms-only group were independently higher for Black patients (odds ratio, 2.07), for women (odds ratio, 1.39), and with younger age (odds ratio, 1.12 per 10 years). Compared with White patients, Black patients had a significantly longer median time to appropriate antibiotic treatment (35 versus seven days); this was significant among patients with EM (26 versus four days).

“We identified several racial differences in the clinical presentation and treatment of LD,” the authors write. “Efforts are needed to increase patient and clinician awareness to ensure equitable reductions in disease burden.”

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One author had a patent issued for deep learning for Lyme disease diagnosis.

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