From the Guidelines
The recommended dosage of Doxycycline for the treatment of Lyme disease in adults is 100 mg taken orally twice daily. This dosage is based on the guidelines provided by the Infectious Diseases Society of America, as outlined in the study published in Clinical Infectious Diseases 1. The exact duration of treatment depends on the stage and severity of the infection, with early localized Lyme disease typically requiring 10 days of treatment, while more advanced cases may need the full 21 days. For children weighing less than 45 kg (99 lbs), the recommended dose is 4 mg/kg per day in 2 divided doses, not exceeding the adult dose, as stated in the guidelines 1.
Important Considerations
- Doxycycline should be taken with a full glass of water, and patients should remain upright for at least 30 minutes after taking it to prevent esophageal irritation.
- Food doesn't significantly affect absorption, but taking it with food may reduce stomach upset.
- Patients should avoid dairy products, antacids, iron supplements, and calcium supplements within 2 hours of taking doxycycline as these can reduce its effectiveness.
- Sun protection is essential during treatment as doxycycline increases photosensitivity.
- Doxycycline is effective against Lyme disease because it targets the bacterial ribosome, inhibiting protein synthesis in the Borrelia burgdorferi bacteria that causes the infection.
Special Populations
- For children under 8 years of age, doxycycline is not recommended due to the risk of tooth discoloration and other adverse effects 1.
- Pregnant or lactating women should avoid doxycycline due to the potential risks to the fetus or baby 1.
Treatment Duration
- The treatment duration for Lyme disease with doxycycline can range from 10 to 21 days, depending on the severity of the infection and the patient's response to treatment 1.
- Patients with early localized Lyme disease may only require 10 days of treatment, while those with more advanced disease may need the full 21 days.
From the Research
Recommended Dosage of Doxycycline for Lyme Disease
The recommended dosage of Doxycycline for the treatment of Lyme disease is as follows:
- For adults, 100 mg twice daily for 14 days (erythema migrans) to 21 days (early localized Lyme disease with associated symptoms) 2
- For children above 8 years of age, 4 mg/kg/day in 2 intakes, maximum 100 mg/dose 2
- Alternatively, 100 mg twice daily 3
Duration of Antibiotic Therapy
The duration of antibiotic therapy for early Lyme disease has been evaluated in several studies:
- A randomized, double-blind, placebo-controlled trial found that 10 days of oral doxycycline was as effective as 20 days of oral doxycycline in treating patients with early Lyme disease 4
- Another study recommended treating adults with doxycycline for 3 to 4 weeks for early localized Lyme disease 3
Comparison with Other Antibiotics
Doxycycline has been compared with other antibiotics in the treatment of Lyme disease:
- A network meta-analysis found that oral amoxicillin, oral azithromycin, injectable ceftriaxone, and injectable cefotaxime were effective for treating Lyme disease, but did not observe significant efficacy and safety of doxycycline for treating Lyme disease 5
- Another study found that doxycycline, amoxicillin, and ceftriaxone were the antibiotics of choice for treating Lyme borreliosis 6