What is given to adults after a tick bite? - briefly
Adults are typically prescribed a single 200 mg dose of doxycycline to prevent Lyme disease, and they receive a tetanus booster if their immunization status is uncertain.
What is given to adults after a tick bite? - in detail
The management of an adult patient after a tick attachment focuses on prompt removal, assessment of infection risk, and appropriate prophylactic measures.
The first step is to grasp the tick firmly with fine‑point tweezers, pull upward with steady pressure, and clean the site with antiseptic. Documentation of the tick’s species, engorgement level, and attachment duration aids risk evaluation.
Prophylactic antibiotics are indicated when the following criteria are met: exposure to Ixodes scapularis or Ixodes pacificus, bite occurring within 72 hours, the tick is estimated to have been attached for ≥ 36 hours, and local incidence of Lyme disease exceeds 20 cases per 100 000 population. In such circumstances, a single dose of doxycycline 200 mg orally is recommended. Contraindications include pregnancy, lactation, known hypersensitivity, and severe hepatic impairment; alternative agents such as amoxicillin 2 g single dose may be considered, though evidence for efficacy is limited.
Tetanus status should be verified. If the patient’s immunization record is outdated (more than 10 years since the last booster) or uncertain, a tetanus toxoid booster (Td or Tdap) is administered concurrently with the antibiotic regimen.
Supportive care includes:
- Analgesics (e.g., ibuprofen 400 mg every 6 hours) for local pain or inflammation.
- Antihistamines if itching or mild allergic reactions develop.
- Observation for early signs of erythema migrans, fever, headache, or arthralgia; patients should be instructed to seek medical evaluation if symptoms appear within 30 days.
Follow‑up arrangements involve a telephone or clinic visit 2–4 weeks post‑exposure to assess for delayed manifestations. If Lyme disease develops despite prophylaxis, a full treatment course of doxycycline 100 mg twice daily for 14–21 days, or an alternative regimen (amoxicillin or cefuroxime), is prescribed.
In summary, adult care after a tick bite comprises immediate removal, risk‑based single‑dose doxycycline prophylaxis, tetanus immunization when indicated, symptomatic relief, and scheduled monitoring for delayed infection.