How is treatment for Lyme tick performed? - briefly
Treatment involves a course of antibiotics, most commonly oral doxycycline for 10–21 days in early cases, while later or severe manifestations may require intravenous ceftriaxone for 14–28 days. Prompt therapy reduces the risk of chronic joint, neurological, or cardiac complications.
How is treatment for Lyme tick performed? - in detail
Treatment of Lyme disease caused by Borrelia burgdorferi requires antimicrobial therapy tailored to disease stage and patient characteristics. Early localized infection, typically presenting with erythema migrans, is managed with oral doxycycline 100 mg twice daily for 10–14 days. Alternatives include amoxicillin 500 mg three times daily or cefuroxime axetil 500 mg twice daily for the same duration, chosen for patients with contraindications to tetracyclines.
Disseminated manifestations—multiple erythema migrans lesions, neurological involvement, or cardiac conduction abnormalities—may necessitate longer courses. Oral doxycycline 100 mg twice daily for 21 days is standard for neurologic involvement without meningitis. When meningitis or severe radiculoneuritis occurs, intravenous ceftriaxone 2 g once daily for 14–28 days is recommended. Intravenous cefotaxime 2 g three times daily serves as an equivalent option.
Joint involvement (Lyme arthritis) often responds to oral doxycycline or amoxicillin for 28 days. Persistent synovitis after initial therapy may require a second, extended oral regimen or a brief course of intravenous ceftriaxone.
Special populations demand dosage adjustments. Pregnant or lactating individuals receive amoxicillin 500 mg three times daily for 14–21 days; doxycycline is avoided. Pediatric patients under eight years receive amoxicillin 50 mg/kg/day divided three times daily; cefuroxime axetil is an alternative.
Adjunctive measures include anti-inflammatory agents for arthritic pain and, when indicated, temporary pacing for high-degree atrioventricular block until antimicrobial effect restores conduction. Monitoring of clinical response occurs at the end of therapy; lack of improvement prompts re‑evaluation for alternative diagnoses, drug resistance, or inadequate drug levels.
In cases of treatment failure or relapse, repeat a full course of the appropriate antibiotic, considering a different class to avoid resistance. Documentation of drug allergies, renal or hepatic impairment, and concomitant medications guides selection and dosing throughout the therapeutic course.