What is prescribed for children after a tick bite? - briefly
A single dose of amoxicillin (or amoxicillin‑clavulanate) is prescribed within 72 hours of a tick bite to prevent Lyme disease in children under eight. In children older than eight, a short course of doxycycline may be used as prophylaxis.
What is prescribed for children after a tick bite? - in detail
A thorough approach after a bite by a hard‑body tick in a pediatric patient begins with immediate removal of the arthropod using fine tweezers, grasping the head as close to the skin as possible, and pulling straight outward. The site should be cleaned with antiseptic solution and inspected for signs of attachment duration.
If the tick has been attached for less than 24 hours, prophylactic treatment is generally not required. When attachment exceeds 36 hours, or when the bite occurs in an area endemic for Borrelia burgdorferi, a single dose of doxycycline (4 mg/kg, not to exceed 200 mg) is recommended for children aged eight years and older. For younger patients, doxycycline is avoided due to the risk of dental staining; instead, a seven‑day course of amoxicillin (50 mg/kg/day divided three times) is the preferred alternative.
In regions where Anaplasma phagocytophilum or Ehrlichia spp. are prevalent, a five‑day regimen of doxycycline (4 mg/kg twice daily) is indicated for children eight years and older. For those under eight, the same amoxicillin protocol is used, recognizing that it does not cover these organisms but may be chosen if coinfection risk is low.
Monitoring guidelines include:
- Daily temperature checks for fever exceeding 38 °C.
- Observation for erythema migrans: expanding red rash, typically 5–10 cm in diameter, appearing 3–30 days post‑bite.
- Documentation of headache, fatigue, joint pain, or neurologic symptoms.
- Prompt medical evaluation if any of the above develop.
If a rash or systemic signs appear, treatment shifts from prophylaxis to full therapeutic regimens:
- Lyme disease: doxycycline 4 mg/kg twice daily for 21 days (≥8 years) or amoxicillin 50 mg/kg three times daily for 21 days (≤7 years).
- Anaplasmosis/Ehrlichiosis: doxycycline 4 mg/kg twice daily for 10–14 days (≥8 years) or alternative agents such as rifampin for younger children under specialist guidance.
Vaccination against tick‑borne illnesses is not available; prevention relies on clothing, repellents containing 20 % DEET or picaridin, and regular body checks after outdoor exposure.
The care plan should be recorded, including tick identification, removal method, prophylactic medication administered, dosage, and follow‑up schedule. Parents receive written instructions on symptom vigilance and emergency contact numbers.