How to treat Lyme disease after a tick bite in a child? - briefly
Administer an age‑appropriate antibiotic regimen—typically doxycycline for children over eight or amoxicillin for younger patients—for 10–14 days as soon as possible after the bite, and observe for rash, fever, or joint pain. If clinical signs appear, confirm infection with serologic testing and modify treatment if necessary.
How to treat Lyme disease after a tick bite in a child? - in detail
When a child is bitten by a tick and Lyme disease is suspected, begin with a thorough skin examination. Remove the tick promptly using fine‑point tweezers, grasping close to the skin and pulling straight upward. Preserve the specimen for identification if possible.
Assess for early signs such as an erythema migrans rash, fever, headache, fatigue, or joint pain. If the rash is present, clinical diagnosis is sufficient; laboratory testing is optional but may include enzyme‑linked immunosorbent assay (ELISA) followed by Western blot confirmation.
Administer antibiotics as soon as infection is confirmed or strongly suspected. Recommended regimens for uncomplicated cases are:
- Doxycycline 4 mg/kg per dose (maximum 200 mg) twice daily for 10 days; contraindicated for children under 8 years.
- Amoxicillin 50 mg/kg per day divided every 8 hours for 14 days; preferred for infants and younger children.
- Cefuroxime axetil 30 mg/kg per day divided every 12 hours for 14 days; alternative for those unable to tolerate amoxicillin.
Monitor the child for symptom resolution within 48–72 hours after therapy begins. Persistent fever, worsening joint swelling, or new neurological signs warrant re‑evaluation, possible intravenous ceftriaxone (50–75 mg/kg once daily for 14–28 days), and referral to a pediatric infectious‑disease specialist.
Schedule follow‑up visits at 2 weeks and 6 weeks post‑treatment to confirm clinical improvement and to assess for late manifestations such as arthritis or neurocognitive changes. Document any adverse drug reactions promptly.
Prevent future exposure by educating caregivers on tick‑avoidance strategies: use EPA‑registered repellents containing 20 %–30 % DEET on exposed skin, dress children in long sleeves and pants, perform daily tick checks after outdoor activities, and promptly shower to dislodge unattached ticks.
Implement environmental controls in high‑risk areas: keep lawns trimmed, remove leaf litter, and apply acaricides when appropriate. These measures reduce the likelihood of subsequent bites and subsequent infection.