What is prescribed to a child for a tick bite? - briefly
A single dose of doxycycline (4 mg/kg, up to 200 mg) is prescribed for children when the tick bite occurs in a Lyme‑endemic area and the tick was attached for more than 36 hours. If doxycycline is contraindicated, amoxicillin (50 mg/kg/day in two divided doses for 10 days) is used as an alternative.
What is prescribed to a child for a tick bite? - in detail
A pediatric patient who has been bitten by a tick requires immediate removal of the attached arthropod with fine‑tipped tweezers, grasping the head as close to the skin as possible and pulling upward with steady pressure. After extraction, evaluation focuses on the risk of transmission of tick‑borne pathogens, especially Borrelia burgdorferi.
If the bite occurred in an area where Lyme disease is endemic, the following prophylactic regimen is recommended:
- Doxycycline 4 mg/kg (maximum 200 mg) once daily for 10 days; suitable for children ≥8 years old and weighing ≥45 kg.
- For children younger than 8 years or weighing less than 45 kg, amoxicillin 50 mg/kg divided twice daily for 10 days is preferred.
When the tick has been attached for less than 24 hours, prophylaxis may be omitted if local infection rates are low and the bite site is not erythematous. In cases of suspected early localized Lyme disease (erythema migrans present), initiate the same antibiotic courses without waiting for laboratory confirmation.
Additional considerations:
- Rifampin and cefuroxime axetil are alternative agents for patients with doxycycline intolerance.
- Antihistamines may be administered for local itching; dosages follow pediatric guidelines.
- Monitoring for systemic symptoms (fever, headache, joint pain) should continue for at least 30 days post‑bite.
- If neurological or cardiac manifestations arise, refer to infectious disease specialists promptly; intravenous ceftriaxone 50–75 mg/kg every 12 hours for 14–21 days is indicated.
Vaccination against tick‑borne encephalitis is recommended for children residing in endemic regions, administered according to the standard two‑dose schedule with a booster after 5 years.
Documentation of the tick species, attachment duration, and geographic location assists in risk stratification and informs future preventive education.