How is a Borrelia tick bite treated? - briefly
Prompt removal of the tick followed by a course of antibiotics—typically doxycycline, amoxicillin, or cefuroxime for 2–4 weeks—constitutes the standard therapy, with the choice guided by disease stage and patient factors. Symptomatic relief and monitoring for complications complete the management plan.
How is a Borrelia tick bite treated? - in detail
Prompt removal of the attached arthropod with fine‑point tweezers, grasping close to the skin and pulling steadily upward, eliminates the source of infection and reduces pathogen transmission. After extraction, cleanse the site with antiseptic and document the bite’s location and time of exposure.
If the tick has been attached for ≥36 hours in an area where Lyme disease is endemic, a single dose of doxycycline (200 mg for adults, 4 mg/kg for children ≥8 years) is recommended as prophylaxis, provided no contraindications exist. Alternatives for those unable to receive doxycycline include a 10‑day course of amoxicillin (500 mg three times daily for adults) or cefuroxime axetil (500 mg twice daily).
When erythema migrans or other clinical signs appear, initiate systemic antibiotic therapy without waiting for serology. Standard regimens are:
- Doxycycline 100 mg orally twice daily for 14–21 days (adults and children ≥8 years);
- Amoxicillin 500 mg orally three times daily for 14–21 days (children <8 years or doxycycline‑intolerant patients);
- Cefuroxime axetil 500 mg orally twice daily for 14–21 days (alternative for doxycycline intolerance).
Neurological, cardiac, or arthritic manifestations require extended treatment. Intravenous ceftriaxone 2 g daily for 14–28 days is indicated for meningitis, radiculopathy, or severe atrioventricular block. Oral regimens may follow IV therapy for an additional 2–4 weeks.
After completion of antibiotics, evaluate symptom resolution. Persistent fatigue, musculoskeletal pain, or neurocognitive complaints warrant reassessment, possible repeat serology, and consultation with a specialist in infectious diseases or rheumatology. Long‑term follow‑up focuses on functional recovery and monitoring for late‑stage complications such as chronic arthritis or encephalopathy.