What should be done after a tick bite in a person, and which medications should be taken? - briefly
Immediately remove the attached tick with fine‑point tweezers, disinfect the bite area, and obtain medical assessment; high‑risk exposure justifies a single 200 mg dose of doxycycline within 72 hours as prophylaxis. If Lyme disease manifests, administer doxycycline 100 mg twice daily for 10–21 days, or substitute amoxicillin or cefuroxime when doxycycline is contraindicated.
What should be done after a tick bite in a person, and which medications should be taken? - in detail
Remove the attached tick as soon as possible. Grasp the mouthparts with fine‑point tweezers, pull upward with steady pressure, avoid crushing the body. Clean the bite site and hands with alcohol or soap and water. Record the date of the bite and, if possible, preserve the tick for identification.
Observe the wound for at least four weeks. Look for erythema migrans (expanding red rash), fever, chills, headache, muscle aches, joint pain, or neurological signs. Document any symptoms and the time they appear.
Consider a single dose of doxycycline (200 mg) within 72 hours of the bite when the following criteria are met:
- Tick identified as Ixodes species.
- Attachment time estimated at ≥ 36 hours.
- Local incidence of Lyme disease is high.
- No contraindication to doxycycline (e.g., pregnancy, allergy, age < 8 years).
If doxycycline is unsuitable, alternatives include amoxicillin (500 mg three times daily for 10 days) or cefuroxime axetil (500 mg twice daily for 10 days). Initiate therapy promptly; delay reduces effectiveness.
When a rash or systemic manifestations develop, treat according to the specific pathogen:
- Lyme disease: doxycycline 100 mg twice daily for 14–21 days (adults) or amoxicillin 500 mg three times daily for the same duration (children, pregnant patients). Severe neurologic involvement may require intravenous ceftriaxone (2 g daily for 14–28 days).
- Anaplasmosis: doxycycline 100 mg twice daily for 10 days.
- Babesiosis: atovaquone 750 mg daily plus azithromycin 500 mg daily for 7–10 days.
- Rocky Mountain spotted fever: doxycycline 100 mg twice daily for 7–14 days, regardless of age.
Schedule a follow‑up visit after completing therapy. Re‑examine the site, assess symptom resolution, and discuss preventive measures: wear long sleeves, use EPA‑registered repellents, perform daily tick checks, and treat pets with appropriate acaricides.