Lyme disease secondary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ilan Dock, B.S.

Overview

The secondary prevention of Lyme disease may include post exposure prophylaxis with doxycycline in selected 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 include:[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 criteria are fulfilled:
    • The tick is identified as I. scapularis (adult or nymph)
    • The tick is attached for ⩾36 hours. It is estimated by the degree of engorgement of the tick with blood or approximating the time of exposure to the tick.
    • Within 72 hours of tick removal
    • Local infection rate of tick with B. burgdorferi is ⩾20%
    • There is no contraindication to use of doxycycline.

References

  1. 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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