Lyme disease secondary prevention
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Anmol Pitliya, M.B.B.S. M.D.[2]
Overview
The secondary prevention of Lyme disease may include post exposure prophylaxis with doxycycline in select cases meeting criteria for chemoprophylaxis.
Secondary prevention
- After a tick bite, routine use of antibiotic prophylaxis is not recommended.
- The secondary prevention of Lyme disease may include post exposure prophylaxis with doxycycline in selected cases meeting criteria for chemoprophylaxis.
- The criteria for chemoprophylaxis includes:[1]
- A single dose of doxycycline (avoid in pregnancy and children <8 years) may be offered to adults (200mg) and children (4mg/kg, maximum 200mg) if all of the following criteria are fulfilled:
- The tick is identified as I. scapularis (adult or nymph).
- The tick has been attached for > 36 hours. Attachment time is estimated by the degree of engorgement of the tick with blood or approximating the time of exposure to the tick.
- Prophylaxis should be stated within 72 hours of tick removal.
- Local infection rate of ticks with B. burgdorferi is > 20%.
- There is no contraindication to use of doxycycline.
References
- ↑ Wormser GP, Dattwyler RJ, Shapiro ED, Halperin JJ, Steere AC, Klempner MS; et al. (2006). “The clinical assessment, treatment, and prevention of lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases Society of America”. Clin Infect Dis. 43 (9): 1089–134. doi:10.1086/508667. PMID 17029130.
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