How to treat Lyme disease after a tick bite in a person? - briefly
Begin oral antibiotic therapy promptly—commonly doxycycline 100 mg twice daily for 10–21 days, with amoxicillin or cefuroxime as alternatives when doxycycline is unsuitable. Monitor symptoms and conduct serologic testing if the rash or systemic signs persist, adjusting treatment as needed.
How to treat Lyme disease after a tick bite in a person? - in detail
When a tick is found attached, remove it promptly with fine‑tipped tweezers, grasping the head as close to the skin as possible and pulling straight upward. Clean the bite area with antiseptic; no prophylactic ointments are required beyond this step.
Observe the site for up to 30 days. An expanding erythema migrans lesion, usually beginning as a red macule and enlarging to a bull’s‑eye pattern, signals infection. Record the date of bite, geographic location, and any symptoms such as fever, headache, fatigue, or joint pain, because these details guide diagnostic decisions.
If the characteristic rash appears, initiate antibiotic therapy without waiting for laboratory confirmation. Recommended regimens include:
- Doxycycline 100 mg orally twice daily for 10–21 days (first‑line for adults and children ≥ 8 years).
- Amoxicillin 500 mg orally three times daily for 14–21 days (alternative for pregnant patients, infants, or doxycycline‑intolerant individuals).
- Cefuroxime axetil 500 mg orally twice daily for 14–21 days (another alternative for doxycycline‑intolerant cases).
For patients with early neurologic involvement (e.g., facial palsy, meningitis) or cardiac manifestations, intravenous ceftriaxone 2 g daily for 14–28 days is indicated. In cases of late disseminated disease with arthritis, a longer oral course of doxycycline or amoxicillin (up to 28 days) may be required, and joint aspiration can guide further management.
Serologic testing (ELISA followed by Western blot) is appropriate when the rash is absent or when the diagnosis is uncertain. Positive results confirm exposure but do not replace clinical judgment; treatment decisions should still be based on symptomatology and exposure risk.
After completing antibiotics, schedule a follow‑up visit to evaluate symptom resolution. Persistent fatigue, musculoskeletal pain, or neurocognitive complaints may warrant referral to a specialist for possible post‑treatment Lyme disease syndrome. Additional supportive care—physical therapy for joint stiffness, analgesics for pain, and counseling for mood disturbances—can improve recovery.
Preventive measures reduce future risk: wear long sleeves and pants in endemic areas, apply EPA‑registered repellents containing DEET or picaridin, and conduct daily tick checks. Prompt removal and early antimicrobial intervention remain the most effective strategy to avoid chronic complications.