What to do if bitten by a tick: what medications? - briefly
Remove the tick promptly with fine‑point tweezers, clean the bite site, and, if the bite occurred within 72 hours in an area where Lyme disease is common, a single dose of doxycycline (200 mg for adults, weight‑adjusted for children) is recommended; otherwise, monitor for rash, fever, or joint pain and seek medical evaluation if symptoms develop.
What to do if bitten by a tick: what medications? - in detail
If a tick attaches to the skin, immediate removal is the first priority. Grasp the tick with fine‑point tweezers as close to the surface as possible, pull upward with steady pressure, and disinfect the bite site with an alcohol swab or iodine solution.
After extraction, assess the risk of infection. The most common concern is Lyme disease, transmitted by Borrelia burgdorferi in many regions, but other pathogens such as Anaplasma, Ehrlichia, and tick‑borne encephalitis viruses may also be involved. The choice of medication depends on the duration of attachment, geographic prevalence of pathogens, and the presence of symptoms such as fever, rash, or joint pain.
Pharmacologic options
- Doxycycline – 100 mg orally twice daily for 10–21 days; first‑line for early Lyme disease, anaplasmosis, and ehrlichiosis in adults and children ≥8 years.
- Amoxicillin – 500 mg orally three times daily for 14–21 days; alternative for patients who cannot tolerate doxycycline, including pregnant women and young children.
- Cefuroxime axetil – 250 mg orally twice daily for 14–21 days; another doxycycline substitute, effective against early Lyme disease.
- Azithromycin – 500 mg on day 1, then 250 mg daily for 4 days; considered when macrolide therapy is required, though less effective than doxycycline.
- Rifampin – 600 mg orally once daily for 14 days; reserved for cases where first‑line agents fail or for severe neurologic involvement.
- Intravenous ceftriaxone – 2 g daily for 14–28 days; indicated for late‑stage manifestations such as meningitis, radiculopathy, or severe cardiac involvement.
For tick‑borne encephalitis, no specific antiviral therapy exists; supportive care and, where available, vaccination prior to exposure are recommended. If a patient develops a characteristic erythema migrans rash within 30 days of the bite, initiate antibiotic treatment without waiting for serologic confirmation.
Follow‑up measures
- Monitor for fever, headache, fatigue, muscle aches, or joint swelling for up to 30 days.
- Repeat serology if initial test is negative but symptoms develop later.
- Document the tick’s removal date, estimated attachment time, and geographic location to guide risk assessment.
Prompt tick removal, appropriate antibiotic selection, and vigilant observation together reduce the likelihood of chronic complications.