What to take after a tick bite for adult prophylaxis? - briefly
A single dose of doxycycline 200 mg administered within 72 hours of tick removal is recommended for adult prophylaxis in high‑risk Lyme disease areas. If doxycycline is contraindicated, medical evaluation should be obtained for alternative treatment.
What to take after a tick bite for adult prophylaxis? - in detail
After a tick attachment, immediate removal with fine‑tipped tweezers is essential; grasp the tick as close to the skin as possible, pull upward with steady pressure, and disinfect the bite site. Prophylaxis aims to prevent transmission of Borrelia burgdorferi and other tick‑borne pathogens.
The primary adult regimen consists of a single dose of doxycycline 200 mg taken orally within 72 hours of removal, provided the tick was attached for ≥ 36 hours and the local incidence of Lyme disease exceeds 20 cases per 100 000 population. This dosage achieves serum concentrations sufficient to inhibit early spirochete replication.
Alternative agents are indicated when doxycycline is contraindicated:
- Azithromycin 500 mg orally in a single dose, effective for patients with doxycycline hypersensitivity or pregnant individuals.
- Cefuroxime axetil 500 mg orally twice daily for 5 days, reserved for severe allergy to tetracyclines.
Special populations require adjustments:
- For adults with severe renal impairment (creatinine clearance < 30 mL/min), reduce doxycycline to 100 mg single dose.
- Pregnant or lactating women should receive azithromycin; doxycycline is avoided due to fetal bone and teeth effects.
- Immunocompromised patients may benefit from a full 10‑day doxycycline course (100 mg twice daily) even if the single‑dose criteria are met.
Monitoring after prophylaxis includes:
- Observation of the bite site for erythema migrans or systemic symptoms within 30 days.
- Laboratory testing (ELISA followed by Western blot) if signs of infection appear.
- Documentation of medication intake and adverse reactions.
If prophylaxis is not administered within the 72‑hour window, initiate early diagnostic evaluation and consider therapeutic courses rather than preventive dosing.