How should doxycycline be taken to prevent borreliosis after a tick bite? - briefly
Take 100 mg doxycycline orally once daily, starting as soon as possible (preferably within 72 hours) after the tick bite, and continue the course for 10–14 days.
How should doxycycline be taken to prevent borreliosis after a tick bite? - in detail
Doxycycline is the preferred antimicrobial for post‑exposure prophylaxis of Lyme disease after a confirmed or strongly suspected tick attachment. The regimen consists of a single oral dose of 200 mg taken as soon as possible, ideally within 72 hours of the bite. Evidence shows that this timing maximizes efficacy in preventing infection by Borrelia burgdorferi.
Key points for proper administration:
- Dosage: 200 mg (one 100 mg tablet taken twice, or one 200 mg tablet) taken once.
- Timing: Initiate therapy no later than three days after removal of the tick.
- Food considerations: The dose may be taken with a full glass of water; avoid lying down for at least 30 minutes to reduce esophageal irritation. Food does not significantly affect absorption, but a light meal can lessen gastrointestinal discomfort.
- Contraindications: Do not prescribe to pregnant or lactating women, children under eight years, or individuals with known hypersensitivity to tetracyclines.
- Adverse effects: Common reactions include mild nausea, photosensitivity, and transient esophagitis. Advise patients to stay hydrated and avoid excessive sun exposure while on the medication.
- Drug interactions: Counsel patients that antacids containing aluminum, calcium, magnesium, or iron can bind doxycycline and reduce its bioavailability; these should be taken at least two hours apart.
If any of the above contraindications apply, alternative prophylaxis (e.g., amoxicillin or cefuroxime) should be considered, following local guidelines. Monitoring for rash, fever, or joint pain after the bite remains essential, as early symptoms may still develop despite prophylaxis.