What should be taken to prevent Lyme disease after a tick bite?

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What should be taken to prevent Lyme disease after a tick bite? - briefly
Administer a single 200 mg dose of doxycycline within 72 hours of tick removal. If doxycycline is contraindicated, prescribe a 10‑day course of amoxicillin or cefuroxime.

What should be taken to prevent Lyme disease after a tick bite? - in detail
After a tick attachment, the primary preventive measure is a single dose of doxycycline, provided the bite meets specific criteria. The medication must be started within 72 hours of removal.

Eligibility for prophylaxis

Tick identified as Ixodes species.
Attachment time estimated at ≥ 36 hours.
Local incidence of Lyme disease ≥ 20 cases per 100,000 population.
No known allergy to tetracyclines, no pregnancy, and the patient is older than 8 years.

Dosage

Doxycycline 200 mg taken orally as a single dose.
For children weighing less than 45 kg, a single dose of 4 mg/kg (maximum 200 mg) is acceptable.

Timing

Initiate treatment as soon as possible, but no later than 72 hours after tick removal. Delayed administration reduces efficacy.

Contraindications and alternatives

If doxycycline is contraindicated, consider amoxicillin 500 mg orally three times daily for 21 days, or cefuroxime axetil 500 mg twice daily for 21 days.
Pregnant or breastfeeding individuals should receive amoxicillin; children under 8 years should also receive amoxicillin.

Tick removal

Use fine-tipped tweezers to grasp the tick as close to the skin as possible.
Pull upward with steady, even pressure; avoid crushing the body.
Disinfect the bite site with an alcohol swab after removal.

Follow‑up

Observe the bite area for erythema migrans or other symptoms for up to 30 days.
If a rash or systemic signs develop, initiate a full 21‑day course of doxycycline (100 mg twice daily) regardless of earlier prophylaxis.

These steps constitute the evidence‑based approach to preventing Borrelia infection after a tick bite.