What should be administered after a tick bite? - briefly
Administer a single dose of doxycycline (200 mg) within 72 hours when the tick has been attached for more than 36 hours, the species is a known vector (e.g., Ixodes), and the exposure risk is high; also confirm tetanus immunization status and give a booster if the patient is not up to date.
What should be administered after a tick bite? - in detail
After a tick attachment, the first action is to remove the parasite promptly. Grasp the tick as close to the skin as possible with fine‑point tweezers, pull upward with steady pressure, and avoid crushing the body. Once detached, cleanse the bite area and surrounding skin with soap and water or an antiseptic solution.
The next step is to assess the need for prophylactic treatment. For bites by Ixodes species in regions where Lyme disease is common, a single dose of doxycycline (200 mg for adults, 4 mg/kg for children ≥8 years, not exceeding 200 mg) administered within 72 hours reduces the risk of infection. Doxycycline is contraindicated in pregnant women and children under eight; in those cases, a 10‑day course of amoxicillin (500 mg three times daily for adults, weight‑based dosing for children) is recommended.
If the bite occurred in an area endemic for tick‑borne encephalitis (TBE), a dose of inactivated TBE vaccine should be given as soon as possible, ideally within two weeks of exposure, to initiate protective immunity. For individuals with known allergies to vaccine components, consult an allergist before administration.
In cases where the tick is identified as a carrier of Rocky Mountain spotted fever (RMSF) or other rickettsial diseases, initiate doxycycline (100 mg twice daily for adults, 2.2 mg/kg twice daily for children) for a minimum of seven days, regardless of symptom presence.
When the tick is attached for more than 24 hours and the patient shows signs of tick paralysis—progressive weakness, ataxia, or respiratory difficulty—hospital admission is required. Supportive care includes respiratory monitoring and, if needed, mechanical ventilation until the toxin clears after tick removal.
Follow‑up includes:
- Monitoring the bite site for erythema, expanding rash, or necrosis for at least four weeks.
- Recording systemic symptoms such as fever, headache, myalgia, joint pain, or neurological changes.
- Prompt medical evaluation if any of these manifestations appear, as early treatment improves outcomes.
Vaccination history, travel itinerary, and local tick‑borne disease prevalence should guide the choice of prophylaxis and follow‑up strategy.