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Infection
Lyme Disease Possible therapeutic alternatives
Tick Exposure Borrelia burgdorferi
Prompt tick removal. Single dose doxycycline 200mg if: <72hr in epidemic area (NEJM 2001;345:79)

Prophylactic:  Doxycycline 200mg orally x 1 within 72 hours post tick bite - 87% effective, best only in highly endemic region.
Lyme disease - Erythema migrans  
Preferred: Doxycycline 100mg orally twice daily x 10-14 days. 
Alternatives:
Amoxicillin 500mg orally three times daily x 14-21 days or 
Cefuroxime axetil (Ceftin) 500mg orally twice daily  x 14-21 days.
 
Lyme disease - Early Disseminated or Late complications
Bells palsy: 
Doxycycline 100mg orally twice daily x 21-28 days or 
Amoxicillin 500mg orally three times daily x 21-28 days.
CNS (other): 
Ceftriaxone 2g IV q12h x 14-28 days or 
Cefotaxime 2g IV q6h x 14-28 days or 
Penicillin G  4 MU IV q 4h x 14-28 days.
Cardiac first degree block: 
Doxycycline 100mg orally twice daily x 21-28 days or 
Amoxicillin 500mg orally three times daily x 21-28 days.
Arthritis - 
oral: Doxycycline 100mg orally twice daily x 28 days or Amoxicillin 500mg orally three times daily x 28 days.

IV: Cefotaxime 2g IV q8h x 14-28 days or Penicillin G 18-24 mil U IV qd x 14-28 days.

Images

Tick bite

References - Infectious Disease Section
Infectious Disease References

Disclaimer
The authors make no claims of the accuracy of the information contained herein; and these suggested doses are not a substitute for clinical judgement. Neither GlobalRPh Inc. nor any other party involved in the preparation of this program shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material.
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