What is the management of a tick bite in a 1-year-old child in New South Wales?

From the Guidelines

For a 1-year-old with a tick bite in New South Wales, the most appropriate management is to remove the tick promptly using fine-tipped tweezers, grasping it as close to the skin as possible and pulling upward with steady pressure, as recommended by the 2024 American Heart Association and American Red Cross guidelines for first aid 1.

Key Management Steps

• Remove the tick as soon as possible to minimize the risk of disease transmission, following the method described in the guidelines 1.
• Clean the bite area with soap and water or antiseptic to reduce the risk of infection.
• Monitor the child for symptoms like rash, fever, or unusual irritability for several weeks, as ticks in NSW can transmit diseases such as tick typhus and Queensland tick typhus, though Lyme disease is not considered endemic in Australia.
• If the child develops a rash (particularly a bull's-eye pattern), fever, fatigue, or joint pain, seek medical attention immediately.
• Preventive antibiotics are not routinely recommended for tick bites unless symptoms develop, as stated in the clinical practice guidelines by the Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), and American College of Rheumatology (ACR) 1.

Additional Measures

• For pain or discomfort, paracetamol (Panadol) can be given at 15mg/kg every 4-6 hours as needed, not exceeding 4 doses in 24 hours.
• When outdoors in tick-prone areas, dress your child in long sleeves and pants, use age-appropriate insect repellents (preferably those containing picaridin rather than DEET for young children), and check their skin thoroughly after outdoor activities, as recommended by the American Academy of Pediatrics 1.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Management of Tick Bite in a 1-year-old Child in New South Wales

• The management of a tick bite in a 1-year-old child in New South Wales involves monitoring for symptoms of anaphylaxis, such as cutaneous symptoms, and administering adrenaline and steroids as needed 2.
• In cases where the child develops symptoms such as eschar, lymphadenopathy, and fever with an eruption of erythematous papules and pustules, doxycycline 100 mg b.i.d. may be effective in treating the infection 3.
• However, the use of doxycycline as a prophylactic measure to prevent Lyme disease after a tick bite is still being explored, and more research is needed to confirm its effectiveness 4, 5, 6.
• A systematic review and meta-analysis found that antibiotic prophylaxis, particularly single-dose doxycycline, may be effective in preventing Lyme disease after a tick bite, but further confirmation is needed 6.

Considerations for Treatment

• The decision to administer doxycycline or other antibiotics should be made on a case-by-case basis, taking into account the individual child's risk factors and medical history 2, 3.
• Community pharmacists may play a role in managing patients with tick bites and providing access to appropriate post-exposure prophylaxis 5.
• Further research is needed to determine the optimal treatment strategies for preventing Lyme disease after a tick bite in children 4, 6.