From the Guidelines
Doxycycline is recommended as a preventive treatment after a tick bite in high-risk situations, with a single 200mg dose taken within 72 hours of tick removal. For prevention of Lyme disease, this dose is recommended if the tick was attached for at least 36 hours and the individual is in an area where Lyme disease is common 1. The dosage for children is 4.4 mg/kg (up to a maximum dose of 200 mg) 1. When taking doxycycline, it is essential to avoid dairy products, antacids, and supplements containing calcium, magnesium, iron, or zinc for 2 hours before and after taking the medication, as these can reduce absorption.
Key Considerations
- Take the medication with a full glass of water while sitting upright to prevent esophageal irritation.
- Avoid sun exposure as doxycycline increases photosensitivity.
- Doxycycline is effective against Lyme disease because it targets the Borrelia burgdorferi bacteria that causes the infection.
- It's also active against other tick-borne pathogens like Anaplasma and Ehrlichia, making it a good first-line treatment for tick bites 1.
- A tick bite is considered high-risk if it meets the following criteria: the tick bite was from an identified Ixodes spp. vector species, it occurred in a highly endemic area, and the tick was attached for ≥36 hours 1.
Special Populations
- Pregnant women, children under 8, and those with certain allergies should not take doxycycline and should consult their healthcare provider for alternative treatments.
- For high-risk Ixodes spp. bites in all age groups, the administration of a single dose of oral doxycycline within 72 hours of tick removal is recommended over observation (strong recommendation, moderate-quality evidence) 1.
From the FDA Drug Label
Doxycycline is indicated for the treatment of the following infections: Rocky Mountain spotted fever, typhus fever and the typhus group, Q fever, rickettsialpox, and tick fevers caused by Rickettsiae.
- Tick bite treatment: Doxycycline is indicated for the treatment of tick fevers caused by Rickettsiae, which can be transmitted through tick bites.
- Key points:
- Doxycycline is effective against Rickettsiae infections.
- It is used to treat tick fevers caused by these bacteria.
- The treatment is based on the presence of susceptible bacteria 2. Doxycycline can be used for the treatment of tick bite infections caused by Rickettsiae.
From the Research
Tick Bite Treatment with Doxycycline
- Doxycycline is used as a prophylactic treatment to prevent Lyme disease after a tick bite, with studies showing its effectiveness in preventing the disease 3, 4, 5, 6, 7.
- A single dose of 200mg of doxycycline has been shown to be effective in preventing Lyme disease, with a relative risk reduction of 67% 7.
- The timing of doxycycline administration is crucial, with studies suggesting that it is most effective when given promptly after tick removal, ideally within 72 hours 4, 7.
- Doxycycline prophylaxis may be underprescribed for certain groups, including children, and pharmacist-initiated antibiotic therapy may help enhance public access to prophylaxis 3, 6.
Efficacy of Doxycycline Prophylaxis
- Studies have demonstrated the efficacy of doxycycline prophylaxis in preventing Lyme disease, with a number-needed-to-treat of 51 7.
- Doxycycline has been shown to be effective in preventing Lyme borreliosis after an Ixodes ricinus tick bite, with no serious adverse events reported 7.
- The use of doxycycline as a prophylactic treatment has been recommended for individuals who have been bitten by a tick in endemic areas, particularly those with a high risk of Lyme disease 5.
Administration and Dosage
- A single dose of 200mg of doxycycline is typically administered orally, ideally within 72 hours of tick removal 4, 7.
- Doxycycline can be dispensed by pharmacists, who can also provide counseling on the use of the medication and the signs and symptoms of Lyme disease 6.
- The use of doxycycline as a prophylactic treatment should be guided by clinical judgment and individual patient risk factors 5.