If a tick bit, which antibiotics should be taken? - briefly
First‑line therapy after a tick bite is doxycycline, 100 mg twice daily for 10‑21 days, covering Lyme disease, anaplasmosis and other common tick‑borne infections. Alternatives include amoxicillin for patients who cannot receive doxycycline and azithromycin for specific indications.
If a tick bit, which antibiotics should be taken? - in detail
A tick bite may transmit Borrelia burgdorferi and other pathogens; antibiotic treatment is indicated when clinical or epidemiological criteria suggest infection.
First‑line agents for early Lyme disease include:
- Doxycycline 100 mg orally twice daily for 10–21 days. Preferred for adults and children ≥8 years. Also effective against Anaplasma phagocytophilum.
- Amoxicillin 500 mg orally three times daily for 14–21 days. Alternative for patients unable to take doxycycline, including pregnant women and children <8 years.
- Cefuroxime axetil 250 mg orally twice daily for 14–21 days. Suitable for doxycycline intolerance and for patients with renal impairment when dose is adjusted.
For patients with severe manifestations (e.g., meningitis, carditis, or high‑grade neurologic involvement), intravenous therapy is recommended:
- Ceftriaxone 2 g intravenously once daily for 14–28 days.
- Alternative: Penicillin G 18–24 million IU per day, divided every 4 hours, for the same duration.
Special considerations:
- Pregnant or lactating patients: amoxicillin remains the preferred oral agent; ceftriaxone is acceptable for intravenous treatment.
- Children <8 years: amoxicillin or cefuroxime, dosed according to weight, replace doxycycline.
- Known hypersensitivity to β‑lactams: doxycycline is the oral alternative; azithromycin may be used in selected cases, though efficacy data are limited.
Therapy should begin promptly after diagnosis is confirmed or strongly suspected. Duration depends on disease stage and organ involvement; standard courses range from 10 to 28 days. Clinical response is monitored through symptom resolution and, when necessary, serologic testing. Adverse effects, such as gastrointestinal upset with doxycycline or allergic reactions to β‑lactams, require assessment and possible regimen adjustment.