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Will Rhode Island Lyme disease program cause pharmacist error?

Lyme disease is an illness caused by a bacteria carried by ticks. The disease can cause severe headaches, neck stiffness, arthritis, joint pain, facial palsy and problems with short-term memory. Rhode Island is one of 14 states with Lyme Disease-carrying ticks and is a hotspot for Lyme disease cases. Pharmacies have expanded their role in prescribing medicines across the state under what is called collaborative practice agreements and are now able to give doxycycline to patients who have been bitten by ticks within a 72 hour window. Some feel that pharmacist error in diagnosing and assessing the tick bite will lead to increased antibiotic resistance. 

The new program allows individuals who have been bitten by a tick to come into a pharmacy and receive a dose of the antibiotic without a prescription after answering questions about the tick and their condition. The patient will choose the tick that bit them from a chart of potential disease-carrying types of ticks. The pharmacy should follow CDC guidelines for Lyme disease assessment. 

In some cases, the individual seeking treatment did not bring in the tick or a picture of the tick when choosing the tick from the poster. Opponents argue that the evidence used to claim that doxycycline can prevent Lyme disease is weak. From a public health standpoint, overprescription of antibiotics leads to widespread antibiotic resistance. 

How will pharmacists in Rhode Island be held accountable to the standards? Does the pharmacist have a role to play in pharmacist error if a person receives the antibiotic without showing evidence of the tick? A pharmacy error can cause harm to an individual's health. If a person has been harmed by a pharmacist's error, a personal injury attorney can assist with filing a claim for monetary damages. 

Source:, "Fighting Lyme disease: In R.I., a dose of antibiotic without a prescription", Lynn Arditi, July 29, 2017

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