Which medication should be taken after a tick bite?

Question

admin · Accepted Answer

Which medication should be taken after a tick bite? - briefly
A single 200 mg dose of doxycycline taken within 72 hours of tick removal, or a 14‑day course of 100 mg daily, is the standard prophylactic treatment for Lyme disease in endemic areas.

Which medication should be taken after a tick bite? - in detail
After a tick attachment, immediate removal of the arthropod is essential. The decision to start medication depends on the species of tick, duration of attachment, and regional prevalence of tick‑borne pathogens.
Prophylactic antibiotic for Lyme disease

Drug: Doxycycline 200 mg orally, single dose.
Timing: Administer within 72 hours of removal.
Eligibility criteria:

Bite by an adult or nymphal Ixodes scapularis or I. pacificus.
Estimated attachment time ≥ 36 hours.
Local infection rate in ticks ≥ 20 %.
Patient weighs ≥ 15 kg and has no contraindication to doxycycline.

If any criterion is unmet, prophylaxis is not recommended; instead, monitor for early signs of infection.
Alternative regimens

Amoxicillin: 500 mg orally three times daily for 20 days, used when doxycycline is contraindicated (e.g., pregnancy, children < 8 years).
Cefuroxime axetil: 500 mg orally twice daily for 20 days, an option for patients allergic to both doxycycline and amoxicillin.

Rickettsial infections (e.g., Rocky Mountain spotted fever, Mediterranean spotted fever)

First‑line: Doxycycline 100 mg orally twice daily for 7–14 days, regardless of age or pregnancy status.

Babesiosis

Combination therapy: Atovaquone 750 mg orally daily plus azithromycin 500 mg on day 1, then 250 mg daily for 7–10 days. Initiate when parasitemia is confirmed or severe symptoms develop.

Anaplasmosis

Treatment: Doxycycline 100 mg orally twice daily for 10 days; start promptly if fever, leukopenia, or thrombocytopenia appear after a bite.

Symptomatic relief

Antihistamines (e.g., cetirizine 10 mg daily) for localized itching.
NSAIDs (e.g., ibuprofen 400 mg every 6 hours) for pain and inflammation, provided no contraindication.

Follow‑up

Observe the bite site for erythema migrans or expanding rash for up to 30 days.
Record fever, chills, headache, arthralgia, or myalgia; seek medical evaluation if these develop.

The outlined medication choices address the most common pathogens transmitted by ticks and provide dosage, duration, and contraindication guidance for each scenario.