Lyme disease from a tick bite: how to treat? - briefly
Start doxycycline (100 mg orally twice daily) for 10–14 days, switching to amoxicillin or cefuroxime if doxycycline is unsuitable; early therapy eliminates the infection and reduces risk of chronic joint, neurological, or cardiac complications. Monitor symptoms and seek prompt medical review if fever, rash, or neurologic signs persist.
Lyme disease from a tick bite: how to treat? - in detail
The infection transmitted by Ixodes ticks requires prompt medical intervention to prevent chronic complications. Diagnosis relies on clinical presentation—erythema migrans, flu‑like symptoms, arthralgia—and, when necessary, serologic testing for IgM and IgG antibodies. Early recognition allows a short course of oral antibiotics to be highly effective.
First‑line oral regimens
- Doxycycline 100 mg twice daily for 10–21 days (adult and pediatric patients >8 years).
- Amoxicillin 500 mg three times daily for 14–21 days (children, pregnant or lactating women, doxycycline‑intolerant patients).
- Cefuroxime axetil 500 mg twice daily for 14–21 days (alternative for doxycycline intolerance).
Alternative or adjunctive therapy
- Intravenous ceftriaxone 2 g once daily for 14–28 days for neurologic involvement, cardiac manifestations, or severe arthritis unresponsive to oral agents.
- Intravenous penicillin G 3–4 million units every 4 hours for similar indications when ceftriaxone is contraindicated.
Management of specific manifestations
- Neurological symptoms (meningitis, facial palsy): IV ceftriaxone is preferred; duration 14–28 days.
- Cardiac involvement (AV block, myocarditis): IV ceftriaxone, continuous cardiac monitoring, possible temporary pacing.
- Persistent joint swelling: oral doxycycline or amoxicillin for an additional 4 weeks; intra‑articular corticosteroid injection if inflammation persists after antimicrobial therapy.
Follow‑up and monitoring
- Re‑evaluate at 2‑4 weeks after therapy completion; assess resolution of skin lesions, fever, and joint pain.
- Perform repeat serology only if initial test was negative but clinical suspicion remains high; rising antibody titers suggest ongoing infection.
- Document any adverse drug reactions; adjust regimen promptly (e.g., switch from doxycycline to amoxicillin for gastrointestinal intolerance).
Prevention of recurrence
- Educate patients on tick avoidance: use EPA‑approved repellents, wear long sleeves, perform thorough body checks after outdoor exposure.
- Prompt removal of attached ticks within 24 hours reduces transmission risk dramatically.
Effective treatment hinges on early identification, appropriate antibiotic selection based on disease stage and patient factors, and diligent follow‑up to ensure complete resolution.