From the Guidelines
The recommended treatment for Lyme disease is antibiotics, with the specific regimen depending on the stage and severity of infection, and oral doxycycline (100 mg twice daily for 10-14 days) is the first-line treatment for adults, as recommended by the Infectious Diseases Society of America 1.
Key Considerations
- For early localized or early disseminated Lyme disease, alternative options include amoxicillin (500 mg three times daily) or cefuroxime axetil (500 mg twice daily) for the same duration 1.
- Children are typically treated with amoxicillin or, if over 8 years old, doxycycline at weight-appropriate doses 1.
- For more severe cases, including neurological involvement like meningitis, intravenous antibiotics such as ceftriaxone (2 g daily for 14-28 days) may be necessary 1.
- Late-stage Lyme disease often requires longer treatment courses of 2-4 weeks 1.
Important Notes
- Prompt treatment is crucial as antibiotics are most effective when started early, preventing the infection from spreading throughout the body 1.
- The bacterium Borrelia burgdorferi, which causes Lyme disease, is sensitive to these antibiotics, which work by disrupting bacterial cell wall formation or protein synthesis 1.
- Most patients recover completely with appropriate antibiotic therapy, though some may experience lingering symptoms that typically resolve over time 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Recommended Treatment for Lyme Disease
The recommended treatment for Lyme disease varies depending on the stage and severity of the disease.
- For early localized Lyme disease, the following antibiotics are recommended:
- Amoxicillin (50 mg/kg/day in 3 intakes) or doxycycline (100 mg bid) for 14 days (erythema migrans) to 21 days (early localized Lyme disease with associated symptoms) 2
- Cefuroxime axetil (500 mg twice daily for adults or 30 mg/kg/day in 2 intakes, maximum 500 mg/dose, for children), and azithromycin (500 mg/day for adults and 20 mg/kg/day for children for 7-10 days) are second line treatment 2
- For early disseminated infection, the treatment is similar to that of early localized infection, with the addition of intravenous antibiotics for severe cases 3, 4
- For late disseminated infection, intravenous antibiotics such as ceftriaxone or penicillin G are recommended 3, 4
Antibiotic Options
Several antibiotic options are available for the treatment of Lyme disease, including:
- Oral beta-lactam antibacterials (e.g. amoxicillin, cefuroxime axetil) 5
- Oral tetracyclines (e.g. doxycycline) 5
- Macrolides (e.g. azithromycin) 2, 5
- Ceftriaxone and cefotaxime for intravenous use 3, 4, 6
Treatment Duration
The duration of treatment for Lyme disease varies depending on the stage and severity of the disease.
- For early localized Lyme disease, treatment typically lasts for 14-21 days 2, 5
- For early disseminated infection, treatment may last for 2-4 weeks 3, 4
- For late disseminated infection, treatment may last for 2-4 weeks or longer 3, 4
Special Considerations
Special consideration should be given to patients with certain conditions, such as: