What should be done after an infected tick bite?

Immediate Actions After a Tick Bite

Removing the Tick Safely

Tools for Tick Removal

After a tick bite that may have transmitted disease, removing the parasite safely requires specific instruments designed to grasp the mouthparts without crushing the body.

Fine‑point tweezers (straight or curved) made of stainless steel; tip width 1–2 mm allows precise grip on the tick’s head.
Tick removal hooks or “tick key” devices; engineered to slide under the mouthparts and lift them straight out.
Small, flat‑edge forceps with serrated jaws; useful for larger ticks where a broader grip is needed.
Disposable, single‑use grasping tools; eliminate cross‑contamination risk when multiple patients are treated.

Select tools that are clean, non‑slipping, and able to maintain a steady pressure. Sterilize reusable instruments with alcohol or autoclave before each use. Position the instrument as close to the skin as possible, apply steady upward traction, and avoid twisting or jerking motions that could detach the tick’s head. After extraction, place the tick in a sealed container for identification if needed, then disinfect the bite site with an antiseptic solution.

Proper tool choice and technique reduce the chance of residual mouthparts remaining in the skin, which can increase the risk of secondary infection and complicate subsequent medical assessment.

Proper Technique for Removal

When a tick attached to skin shows signs of infection, immediate removal must follow a precise, sterile method to minimize pathogen transmission and tissue damage.

Use fine‑point tweezers or a specialized tick‑removal tool; avoid thumb‑and‑finger pinching.
Grasp the tick as close to the skin surface as possible, securing the mouthparts without crushing the body.
Apply steady, even pressure to pull straight upward; do not twist, jerk, or rock the tick.
After extraction, inspect the bite site; the entire tick, including the head, should be visible. If any part remains, repeat the removal process rather than cutting or digging.
Disinfect the area with an antiseptic solution (e.g., povidone‑iodine or alcohol) and wash hands thoroughly with soap and water.
Preserve the removed tick in a sealed container with a damp cotton ball for potential laboratory identification; label with date and location.
Seek medical evaluation promptly, especially if redness expands, swelling, fever, or a rash develops, as these may indicate Lyme disease, Rocky Mountain spotted fever, or other tick‑borne infections.

Adhering to this protocol reduces the risk of secondary infection and facilitates accurate clinical assessment.

Avoiding Common Mistakes

After a tick bite that has become infected, the most effective response hinges on avoiding actions that can worsen the condition or delay proper treatment.

Do not attempt to extract the tick with tweezers that pinch the body; use fine‑pointed, blunt‑tipped forceps and pull straight upward.
Do not crush the tick or squeeze its abdomen, which can release additional pathogens into the wound.
Do not leave the bite site uncovered; apply a sterile dressing promptly to reduce bacterial entry.
Do not postpone medical evaluation; seek professional care within 24 hours, especially if redness, swelling, or fever develop.
Do not rely on over‑the‑counter ointments or home remedies without a clinician’s approval; many are ineffective against the specific bacteria transmitted by ticks.
Do not ignore systemic symptoms such as headache, muscle aches, or joint pain; these may signal early Lyme disease or other tick‑borne infections.
Do not reuse bandages or apply dirty materials; change dressings regularly with clean, sterile supplies.
Do not neglect personal protective measures for future exposures, including proper clothing and repellents, because repeated bites increase cumulative risk.

Correct handling of the wound, timely professional assessment, and strict adherence to evidence‑based care prevent complications and support faster recovery.

Cleaning and Disinfecting the Bite Area

After a tick bite that shows signs of infection, the first priority is to cleanse the wound thoroughly. Use clean running water to flush the area for at least 30 seconds, removing any debris or tick remnants. Avoid scrubbing aggressively, which can damage surrounding tissue.

Select an antiseptic that is effective against a broad spectrum of microbes. Common options include:

70 % isopropyl alcohol, applied with a sterile gauze pad and allowed to air‑dry.
Povidone‑iodine solution, applied in a thin layer and left for a few minutes before wiping excess.
Chlorhexidine gluconate, especially useful for patients with iodine sensitivity.

Apply the chosen disinfectant using a sterile applicator, covering the entire bite site. Repeat the application once more after five minutes to ensure sustained antimicrobial activity.

After disinfection, cover the wound with a sterile, non‑adhesive dressing. Change the dressing daily, or sooner if it becomes wet or contaminated. Monitor the site for increased redness, swelling, or pus; persistent or worsening symptoms require medical evaluation.

Monitoring for Symptoms and Seeking Medical Attention

Recognizing Early Signs of Infection

Localized Reactions

After a tick bite that has transmitted an infection, the first visible sign is often a localized skin reaction. This reaction typically appears as redness, swelling, or a small papule at the bite site and may develop within hours to a few days.

The immediate response should include:

Gentle cleansing of the area with soap and water; avoid scrubbing, which can aggravate inflammation.
Application of an antiseptic (e.g., povidone‑iodine or chlorhexidine) to reduce bacterial colonization.
Placement of a sterile, non‑adhesive dressing if the skin is broken or oozing.
Monitoring for changes in size, color, or temperature; an expanding erythema or increasing pain suggests a progressing infection.

If the reaction remains confined to the bite site without systemic symptoms, continue local care for 48–72 hours. Re‑evaluate the lesion daily; improvement should be evident as redness diminishes and swelling subsides.

Escalate treatment when any of the following occurs:

Rapid enlargement of the erythematous area (≥5 cm diameter).
Development of a central necrotic core or ulceration.
Presence of pus, foul odor, or increasing tenderness.
Accompanying fever, chills, headache, or joint pain.

In such cases, seek medical evaluation promptly. A clinician may prescribe oral antibiotics targeting common tick‑borne pathogens (e.g., doxycycline for Lyme disease, amoxicillin for cellulitis) and consider further diagnostic testing.

After the acute phase, document the reaction’s duration and characteristics. This information aids future risk assessment and informs healthcare providers about possible hypersensitivity or co‑infection.

Systemic Symptoms

Systemic symptoms signal that a tick‑borne pathogen has entered the bloodstream and may require urgent intervention. Recognizing these signs promptly reduces the risk of severe complications.

Common systemic manifestations include:

Fever or chills above 38 °C (100.4 °F)
Severe headache, often described as throbbing
Muscle or joint pain, sometimes accompanied by swelling
Nausea, vomiting, or abdominal discomfort
Fatigue or malaise disproportionate to the local bite reaction
Dizziness, light‑headedness, or fainting episodes
Enlarged lymph nodes, particularly in the neck, armpit, or groin

When any of these symptoms appear within days to weeks after a tick bite, immediate medical evaluation is warranted. The clinician will likely order laboratory tests (e.g., serology, PCR) to identify the causative organism and prescribe an appropriate antibiotic regimen, such as doxycycline for suspected Lyme disease or amoxicillin for certain rickettsial infections. Early treatment shortens disease duration and prevents organ‑specific damage, such as cardiac involvement or neurological impairment.

Patients should also monitor for symptom progression. Worsening fever, new neurological signs (e.g., facial palsy, meningitis‑like stiffness), or respiratory difficulty constitute medical emergencies and require emergency department care.

In summary, systemic signs after a tick bite demand rapid assessment, targeted diagnostics, and timely antimicrobial therapy to avert serious outcomes.

When to Consult a Doctor

Specific Symptoms Requiring Urgent Care

After a tick bite that appears infected, certain clinical signs demand immediate medical evaluation. Delay can lead to severe complications, including neurological damage or systemic infection.

Fever ≥ 38.5 °C (101.3 °F) persisting more than 24 hours
Rapidly expanding erythema, especially a bullseye lesion larger than 5 cm
Severe headache or neck stiffness suggestive of meningitis
Confusion, disorientation, or altered mental status
Muscle weakness, especially facial droop or difficulty swallowing
Joint swelling with intense pain, limited range of motion, or redness
Nausea, vomiting, or abdominal pain accompanied by fever
Shortness of breath, chest pain, or rapid heartbeat
Unexplained bruising or bleeding, indicating possible blood‑cell involvement

Presence of any listed symptom should trigger urgent care, preferably at an emergency department, to facilitate prompt diagnosis and treatment.

Risk Factors and Medical History

After a tick bite that may be contaminated, evaluating the patient’s risk profile and past health information determines the urgency and type of intervention.

Key risk factors include:

Exposure in regions where Lyme disease, Rocky Mountain spotted fever, or other tick‑borne illnesses are endemic.
Duration of attachment exceeding 24 hours.
Presence of a rash, fever, chills, headache, or joint pain within a week of the bite.
Immunocompromised status, including HIV infection, chemotherapy, or organ transplantation.
Pregnancy, especially in the first trimester.
Age over 50, which correlates with more severe disease courses.

Relevant elements of medical history are:

Prior diagnosis of tick‑borne infections and any previous treatment failures.
Chronic conditions such as rheumatoid arthritis, diabetes, or cardiovascular disease that may complicate infection.
Current use of immunosuppressive medications (e.g., corticosteroids, biologics).
Allergies to antibiotics, particularly doxycycline or amoxicillin.
Vaccination history for diseases like tick‑borne encephalitis where applicable.

These factors guide clinical decisions: high‑risk patients or those with suggestive symptoms often receive immediate prophylactic antibiotics, while low‑risk individuals may be monitored with serologic testing at defined intervals. In cases of contraindicated antibiotics, alternative regimens or specialist referral become necessary. Accurate risk assessment and thorough medical history thus streamline appropriate post‑bite management.

Diagnostic Procedures

Blood Tests and Other Examinations

After a bite from a tick that shows signs of infection, immediate medical evaluation should include laboratory investigations and targeted examinations to identify or exclude tick‑borne diseases.

Blood work typically comprises:

Complete blood count with differential to detect anemia, leukocytosis, or thrombocytopenia.
Liver function panel (ALT, AST, alkaline phosphatase, bilirubin) for hepatic involvement.
Serum creatinine and electrolytes to assess renal function.
C‑reactive protein or erythrocyte sedimentation rate as markers of systemic inflammation.
Specific serologic tests:
- Enzyme‑linked immunosorbent assay (ELISA) for Borrelia burgdorferi antibodies, followed by confirmatory Western blot if positive.
- Indirect immunofluorescence assay (IFA) for Anaplasma phagocytophilum and Ehrlichia chaffeensis.
- Microscopic agglutination test for Rickettsia species.
Molecular diagnostics:
- Polymerase chain reaction (PCR) on whole blood for Borrelia, Babesia, Anaplasma, Ehrlichia, and Rickettsia when early infection is suspected.
Urinalysis for hematuria or proteinuria indicating possible renal involvement.

Physical and focused examinations should accompany the laboratory panel:

Detailed skin inspection for erythema migrans, vesicular lesions, or necrotic ulcers.
Neurological assessment for headache, neck stiffness, facial palsy, or sensory deficits.
Musculoskeletal evaluation for joint swelling or tenderness.
Cardiovascular review, including auscultation for murmurs suggestive of Lyme carditis.
If neurological signs are present, magnetic resonance imaging of the brain and spinal cord is recommended.

These investigations provide a comprehensive picture of the patient’s condition, enabling timely treatment decisions and monitoring of disease progression.

Interpreting Test Results

After a tick bite suspected of transmitting disease, laboratory testing often guides subsequent care. Interpreting the results requires awareness of test characteristics, timing, and clinical context.

Serologic assays for Lyme disease typically begin with an enzyme‑linked immunosorbent assay (ELISA). A negative ELISA performed within the first two weeks of exposure does not exclude infection because antibodies may not yet be detectable. A positive ELISA must be confirmed with a Western blot; the presence of specific IgM or IgG bands determines the stage of disease and informs treatment decisions.

Polymerase chain reaction (PCR) testing can detect pathogen DNA in blood, cerebrospinal fluid, or joint fluid. Positive PCR provides direct evidence of infection but has limited sensitivity in early disease. A negative PCR does not rule out infection, especially when symptoms are present.

When results are ambiguous, consider the following actions:

Repeat serology after 2–3 weeks if the initial test was negative and symptoms persist.
Order a second‑tier test (Western blot) for any positive screening result.
Use PCR selectively for neurologic or arthritic manifestations.
Correlate laboratory data with the patient’s exposure history, rash appearance, and symptom timeline.

Understanding the window periods, specificity, and sensitivity of each assay prevents misinterpretation and ensures appropriate antimicrobial therapy.

Understanding Potential Tick-Borne Diseases

Common Diseases Transmitted by Ticks

Lyme Disease

Lyme disease results from infection with the bacterium Borrelia burgdorferi, which is transmitted through the bite of an infected Ixodes tick. The pathogen can disseminate rapidly, affecting skin, joints, heart, and nervous system if not addressed promptly.

After discovering a tick attachment, follow these steps:

Grasp the tick as close to the skin as possible with fine‑tipped tweezers.
Pull upward with steady, even pressure; avoid twisting or crushing the body.
Disinfect the bite site and hands with alcohol or iodine.
Record the date of removal and note the tick’s developmental stage.
Observe the area for at least 30 days, watching for rash or systemic signs.

Early manifestations typically appear within 3–30 days. The hallmark skin lesion, erythema migrans, expands outward from the bite and may reach 5–10 cm in diameter. Accompanying symptoms often include fever, chills, headache, fatigue, muscle and joint aches.

Seek medical evaluation promptly if any of the following occur:

Expanding red rash, especially with central clearing.
Persistent fever, chills, or malaise.
Joint swelling or pain, particularly in large joints.
Neurological complaints such as facial palsy, meningitis‑like symptoms, or radicular pain.
Cardiac irregularities, including palpitations or chest discomfort.

Diagnosis relies on serologic testing: an initial enzyme‑linked immunosorbent assay (ELISA) followed by confirmatory Western blot if positive. In early disease with characteristic rash, treatment may begin without laboratory confirmation.

Recommended antimicrobial regimens:

Doxycycline 100 mg orally twice daily for 10–21 days (adults and children ≥8 years).
Amoxicillin 500 mg orally three times daily for 14–21 days (children <8 years or doxycycline contraindicated).
Cefuroxime axetil as an alternative for patients unable to tolerate the first‑line agents.

Post‑treatment monitoring includes reassessment of symptoms at 2–4 weeks. Persistent or recurrent manifestations may warrant extended therapy or referral to a specialist.

When the tick has been attached for more than 36 hours and the encounter occurs in a region with high infection prevalence, a single prophylactic dose of doxycycline (200 mg for adults, weight‑adjusted for children) administered within 72 hours can reduce the likelihood of disease onset. This measure complements, but does not replace, the removal and observation protocol.

Anaplasmosis

Anaplasmosis is a bacterial infection transmitted by tick bites. Prompt identification and treatment reduce the risk of severe illness.

If a tick bite is suspected to involve Anaplasma, take the following actions:

Remove the tick with fine‑tipped tweezers, grasping close to the skin and pulling steadily downward.
Clean the bite site with antiseptic.
Record the date of the bite and note any symptoms that develop within two weeks, such as fever, chills, headache, muscle aches, or malaise.
Contact a healthcare provider promptly. Mention recent tick exposure and request testing for Anaplasma phagocytophilum, typically via PCR or serology.
If diagnosis is confirmed or strongly suspected, begin doxycycline 100 mg twice daily for 10–14 days. Doxycycline is the first‑line therapy and halts disease progression.
Complete the full antibiotic course even if symptoms improve early.
Schedule a follow‑up visit to verify resolution of fever and normalization of blood counts, as the infection can cause transient leukopenia or thrombocytopenia.
Maintain a log of any adverse reactions to medication and report them to the prescribing clinician.

Early intervention limits complications such as respiratory failure, renal impairment, or persistent fatigue. Regular monitoring after treatment ensures full recovery.

Babesiosis

Babesiosis is a parasitic infection transmitted by the same ticks that can spread Lyme disease, making it a critical consideration after a bite from a potentially infected tick. The parasite, Babesia microti in most North American cases, invades red blood cells, producing symptoms that range from mild flu‑like illness to severe hemolytic anemia, especially in immunocompromised individuals or those without a spleen.

Prompt medical evaluation is essential. Clinicians should obtain a detailed exposure history, perform a physical examination, and order laboratory tests that include a complete blood count, peripheral blood smear, and polymerase chain reaction (PCR) for Babesia DNA. Detection of intraerythrocytic parasites on a stained smear or a positive PCR confirms the diagnosis.

Treatment protocols typically involve a combination of antimicrobial agents. The standard regimen pairs atovaquone with azithromycin for uncomplicated cases, while severe infections require clindamycin plus quinine. Duration of therapy generally spans 7–10 days, but clinicians may extend treatment based on patient response and parasitemia levels. Monitoring includes repeat blood smears every 48–72 hours until parasites are no longer visible.

Patients should receive counseling on supportive care measures:

Maintain adequate hydration.
Avoid activities that increase the risk of anemia complications.
Report persistent fever, worsening fatigue, or jaundice immediately.

Follow‑up appointments are recommended within two weeks of completing therapy to ensure clearance of the parasite and to assess for potential relapse, which occurs in a minority of cases. Preventive strategies focus on tick avoidance: use repellents containing DEET or picaridin, wear long sleeves and pants in endemic areas, conduct thorough body checks after outdoor exposure, and promptly remove attached ticks with fine‑tipped tweezers.

By recognizing Babesiosis as a possible consequence of a tick bite, seeking timely diagnostic testing, adhering to evidence‑based treatment, and implementing preventive practices, individuals can mitigate the risk of severe disease and promote swift recovery.

Powassan Virus

Powassan virus is a rare but severe flavivirus transmitted by the bite of infected ticks, most commonly Ixodes species. Because the incubation period ranges from 1 to 5 weeks, early recognition of potential exposure is critical. The virus can cause encephalitis, meningitis, or fatal outcomes, especially in immunocompromised individuals and children. Laboratory confirmation requires polymerase chain reaction (PCR) testing or serologic assays for IgM antibodies; these tests are not routinely performed in standard tick‑bite protocols, so clinicians must specifically request them when Powassan infection is suspected.

After a tick bite that may have involved a virus‑carrying vector, the following actions are recommended:

Remove the tick promptly with fine‑tipped tweezers, grasping close to the skin and pulling straight upward; avoid crushing the mouthparts.
Clean the bite area with antiseptic solution.
Document the date of removal, tick attachment duration, and geographic location of exposure.
Monitor for symptoms such as fever, headache, vomiting, confusion, or neurological deficits for up to six weeks.
Seek medical evaluation immediately if any of the above symptoms develop; request Powassan‑specific testing and consider hospital admission for neuroimaging and supportive care.
Inform the healthcare provider of recent travel to endemic regions (e.g., Upper Midwest, New England, parts of Canada) and any prior tick exposures.

Preventive measures include wearing protective clothing, using EPA‑registered repellents containing DEET or picaridin, and performing regular body checks after outdoor activities in tick‑infested habitats. Early detection and appropriate clinical management can reduce morbidity associated with Powassan virus infection.

Treatment Options for Tick-Borne Illnesses

Antibiotic Therapies

After a tick bite that carries a pathogen, prompt antibiotic treatment reduces the likelihood of systemic illness. The choice of drug depends on the suspected organism, patient age, pregnancy status, and allergy profile.

Doxycycline – 100 mg orally twice daily for 10–21 days; preferred for most adult exposures, especially when Borrelia burgdorferi is suspected.
Amoxicillin – 500 mg orally three times daily for 10–21 days; alternative for children under 8 years and for pregnant or lactating patients.
Cefuroxime axetil – 500 mg orally twice daily for 10–21 days; used when doxycycline is contraindicated and amoxicillin is unsuitable.

Special populations require adjustments:

Children < 8 years – amoxicillin is first‑line; doxycycline reserved for severe cases under specialist guidance.
Pregnant or nursing women – amoxicillin or cefuroxime; doxycycline avoided due to fetal risk.
Patients with sulfa or penicillin allergy – cefuroxime or a macrolide (e.g., azithromycin 500 mg on day 1, then 250 mg daily for 4 days) may be considered, though efficacy data are limited.

Therapy should begin as soon as possible, ideally within 72 hours of the bite, when prophylactic criteria are met: attached tick ≥ 36 hours, endemic area, and no contraindication to doxycycline. If treatment starts later, full course therapy is indicated rather than prophylaxis.

Follow‑up includes monitoring for rash, fever, joint pain, or neurologic symptoms. Persistence or progression of symptoms after the prescribed course warrants re‑evaluation, possible extension of therapy, and referral to infectious‑disease specialists.

Supportive Care Measures

After confirming that a tick bite has become infected, initiate local and systemic supportive actions promptly to limit tissue damage and reduce the risk of disseminated illness.

Clean the wound with mild antiseptic solution (e.g., chlorhexidine or povidone‑iodine) and gentle soap; rinse thoroughly.
Apply a sterile, non‑adhesive dressing; replace it daily or when it becomes wet or soiled.
Use a cold compress for 10–15 minutes, several times a day, to diminish swelling and discomfort.
Administer oral analgesics such as ibuprofen or acetaminophen according to dosing guidelines to control pain and fever.
If itching develops, give an antihistamine (e.g., diphenhydramine) or a topical corticosteroid to prevent secondary skin trauma.
Encourage adequate hydration and balanced nutrition to support immune function.
Advise rest and avoidance of strenuous activity until fever resolves and pain is manageable.

Continuously observe the site for expanding erythema, increasing purulence, or new systemic signs (headache, joint pain, malaise). Record temperature twice daily; any rise above 38 °C warrants immediate medical evaluation. Maintain short fingernails and discourage scratching to prevent additional bacterial entry.

If symptoms progress despite these measures—particularly the appearance of a bull’s‑eye rash, severe headache, or neurological deficits—seek urgent professional care for targeted antimicrobial therapy and further diagnostic work‑up.

Preventive Measures and Future Protection

Reducing Exposure to Ticks

Personal Protective Measures

After a tick bite that may have transmitted a pathogen, personal protection focuses on preventing further exposure and limiting disease progression.

Remove the attached tick promptly with fine‑point tweezers, grasping as close to the skin as possible, pulling straight upward without crushing the body.
Disinfect the bite site with an iodine‑based solution or alcohol; avoid excessive rubbing that could irritate the wound.
Wear long sleeves, long trousers, and closed shoes when entering wooded or grassy areas; tuck pants into socks to block tick migration.
Apply EPA‑registered repellents containing DEET, picaridin, or IR3535 to exposed skin and clothing; reapply according to product instructions.
Perform a thorough body inspection after outdoor activity, using a mirror for hard‑to‑see areas such as behind ears, scalp, and groin.
Wash clothing in hot water and tumble‑dry on high heat for at least 10 minutes to kill any unattached ticks.
Limit time spent in high‑risk habitats during peak tick activity (early morning and late afternoon).

These measures reduce the likelihood of additional bites and support early detection, which is critical for effective medical intervention.

Yard and Pet Protection

After a tick bite that has transmitted disease, protect the yard and pets to prevent further exposure. Begin by inspecting the entire property for tick habitats. Remove tall grass, leaf litter, and brush where ticks thrive. Apply a targeted acaricide to perimeter zones, following label instructions and safety guidelines. Maintain a regularly mowed lawn and keep vegetation trimmed away from the house foundation.

For pets, perform a thorough examination within 24 hours of the incident. Use fine‑tipped tweezers to extract any attached ticks, grasping close to the skin and pulling straight upward. Clean the bite site with antiseptic solution. Consult a veterinarian promptly; request prophylactic treatment such as oral or topical acaricides and, if appropriate, a course of antibiotics or doxycycline. Ensure the animal’s vaccination schedule includes tick‑borne disease prevention where available.

Implement ongoing measures to sustain a low‑risk environment:

Install a physical barrier (e.g., wood chip mulch) between lawn and wooded areas.
Deploy tick‑repellent devices or treated bait stations in high‑risk zones.
Schedule quarterly acaricide applications during peak tick season.
Conduct monthly pet checks, especially after outdoor activities.

Document all actions, including dates of yard treatments and veterinary visits, to track effectiveness and adjust strategies as needed.

Post-Bite Prophylaxis

When is Prophylaxis Recommended?

Prophylactic treatment after a tick bite is indicated only when specific risk factors are present. The decision rests on the likelihood that the tick transmitted a pathogen, most commonly Borrelia burgdorferi.

Key conditions for recommending a single dose of doxycycline (200 mg for adults, 4 mg/kg for children ≥8 years) include:

Tick identified as Ixodes scapularis or Ixodes pacificus.
Attachment time of ≥36 hours, confirmed by engorgement or patient recall.
Encounter in a region where the incidence of Lyme disease exceeds 20 cases per 100,000 population.
Patient age ≥8 years, weight ≥15 kg, and no contraindication to doxycycline (e.g., pregnancy, lactation, known allergy).
No prior antibiotic therapy covering B. burgdorferi within the past month.

If any of these criteria are absent, routine prophylaxis is not advised; instead, monitoring for early signs of infection and prompt medical evaluation remain the appropriate course.

Medications Used for Prophylaxis

After a tick bite that has become infected, immediate pharmacologic prevention targets the most common tick‑borne pathogens. The primary drug is doxycycline, administered as a single 200 mg dose within 72 hours of removal. This regimen reduces the risk of early Lyme disease, anaplasmosis, and ehrlichiosis in adults and children weighing at least 15 kg. For patients with contraindications to tetracyclines (pregnancy, severe allergy, or age under 8 years), alternative agents include:

Amoxicillin 500 mg three times daily for 21 days (Lyme disease prophylaxis only).
Cefuroxime axetil 250 mg twice daily for 21 days (alternative for Lyme disease when doxycycline is unsuitable).

If the bite occurs in regions where tick‑borne encephalitis (TBE) is endemic, vaccination before exposure is the only proven prophylaxis; post‑exposure immunoglobulin is not recommended. For babesiosis, prophylactic medication is not standard; treatment begins only after laboratory confirmation.

Dosage adjustments are required for renal impairment (e.g., reduce doxycycline to 100 mg daily) and for hepatic dysfunction (consider cefuroxime). Drug interactions, such as antacids reducing doxycycline absorption, must be avoided by separating administration by at least two hours. Monitoring for adverse effects—photosensitivity, gastrointestinal upset, or allergic reactions—should begin immediately after the first dose.