How to treat after a Lyme tick bite? - briefly
Start a 10‑ to 21‑day antibiotic regimen—typically doxycycline 100 mg twice daily, or amoxicillin/cefuroxime if doxycycline is contraindicated—within 72 hours of removal, and watch for the characteristic rash or flu‑like symptoms, seeking medical evaluation if they appear or persist.
How to treat after a Lyme tick bite? - in detail
After a tick attachment, the first step is to remove the arthropod promptly. Use fine‑point tweezers, grasp the head as close to the skin as possible, and pull upward with steady pressure. Disinfect the bite site with an antiseptic solution such as povidone‑iodine or chlorhexidine.
Assess the bite for signs of infection within 24‑48 hours. Look for erythema, swelling, or a expanding red ring (erythema migrans). Document the date of the bite, geographic location, and any known exposure to endemic areas, as these details guide therapeutic decisions.
If the tick was attached for less than 36 hours and the patient shows no rash or systemic symptoms, a single dose of doxycycline (200 mg) may be administered as prophylaxis, provided the patient is not pregnant, allergic to tetracyclines, or under eight years old. The dose must be taken with food and adequate hydration.
When erythema migrans appears, initiate a full course of antibiotics. Recommended regimens include:
- 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, pregnant women, or doxycycline‑intolerant patients).
- Cefuroxime axetil 500 mg orally twice daily for 14‑21 days (alternative for doxycycline intolerance).
Monitor the patient for resolution of the rash and improvement of symptoms such as fever, headache, fatigue, or joint pain. If symptoms persist after the initial course, consider extending therapy or switching to a second‑line agent such as ceftriaxone 2 g intravenously daily for 14‑28 days, especially for neurological or cardiac involvement.
Supportive care includes:
- Analgesics (acetaminophen or ibuprofen) for pain and fever.
- Rest and hydration.
- Anti‑inflammatory measures for joint swelling, such as compression wraps.
Follow‑up appointments should be scheduled at two‑week intervals to evaluate clinical response and detect late manifestations, including arthritis or neuroborreliosis. Laboratory testing (e.g., ELISA and Western blot) can confirm infection but should not delay the start of therapy when clinical evidence is clear.
Patient education emphasizes the importance of early detection, proper tick removal, and adherence to the full antibiotic regimen to prevent chronic complications.