How is a subcutaneous tick treated with medication? - briefly
A subcutaneous tick should be extracted and followed by a single dose of oral doxycycline (200 mg) to prevent Lyme disease, or a short course of amoxicillin if doxycycline is unsuitable. The patient must be observed for rash or fever for up to 30 days after treatment.
How is a subcutaneous tick treated with medication? - in detail
A tick that has penetrated the dermis and lies beneath the epidermal layer poses a risk of infection and pathogen transmission. Prompt pharmacologic intervention reduces bacterial colonisation, mitigates inflammatory response, and prevents systemic disease.
The first step after mechanical extraction is to cleanse the site with an antiseptic solution (e.g., chlorhexidine 2 %). Topical antimicrobial agents are then applied to the wound. Common choices include:
- 2 % mupirocin ointment, applied three times daily for 5–7 days.
- 1 % fusidic acid cream, applied twice daily for the same period.
If the tick species is known to transmit bacterial agents such as Borrelia or Rickettsia, systemic antibiotics are indicated. Recommended regimens are:
- Doxycycline 100 mg orally, twice daily for 10–14 days (first‑line for most tick‑borne bacterial infections).
- Amoxicillin‑clavulanate 875/125 mg orally, twice daily for 10 days (alternative when doxycycline is contraindicated).
- Azithromycin 500 mg once daily for 3 days (alternative for patients unable to tolerate doxycycline or β‑lactams).
Adjunctive therapy may include:
- A single dose of oral antihistamine (e.g., cetirizine 10 mg) to control itching.
- Non‑steroidal anti‑inflammatory drug (e.g., ibuprofen 400 mg every 6 h) for pain and swelling, limited to 5 days.
- Tetanus booster if immunisation status is uncertain or the wound is contaminated.
Duration of treatment should extend at least 48 h beyond the resolution of local symptoms. Patients must monitor for signs of systemic involvement—fever, rash, arthralgia, or neurological changes—and seek immediate care if these appear.
A follow‑up examination within 7–10 days confirms wound healing and assesses for delayed complications. Documentation of the tick species, removal method, and medication regimen assists in epidemiological tracking and future prevention strategies.