What is the prophylaxis dose of Doxycycline (Doxycycline) for a tick bite?

From the Guidelines

The recommended doxycycline prophylaxis dose for a tick bite is a single 200 mg dose taken orally within 72 hours of tick removal, as indicated by the most recent guidelines from the Infectious Diseases Society of America (IDSA) 1. This approach is specifically indicated when the attached tick is identified as an Ixodes scapularis (deer tick) that has been attached for at least 36 hours, and when prophylaxis can be started within 72 hours of tick removal. The single-dose regimen is effective because doxycycline reaches high blood levels quickly and has a relatively long half-life, allowing it to target Borrelia burgdorferi (the bacteria causing Lyme disease) during its early dissemination phase. Key considerations for administering doxycycline prophylaxis include:

• The tick bite must be from an identified Ixodes spp. vector species
• The bite occurred in a highly endemic area
• The tick was attached for ≥36 hours
• Prophylaxis is started within 72 hours of tick removal Doxycycline should be taken with a full glass of water and can be taken with food to reduce stomach upset. Patients should be advised that doxycycline may cause photosensitivity, so sun protection is recommended. This prophylactic approach is not routinely recommended for all tick bites but is most appropriate in high-risk situations involving deer ticks in endemic areas with prolonged attachment, as supported by the guidelines from the IDSA, American Academy of Neurology (AAN), and American College of Rheumatology (ACR) 1.

From the Research

Doxycycline Prophylaxis Dose for Tick Bite

• The recommended dose of doxycycline for prophylaxis after a tick bite is a single dose of 200 mg, given within 72 hours of tick removal 2, 3.
• This dose has been shown to be effective in preventing the development of Lyme borreliosis in both North America and Europe 2, 3.
• The efficacy of this treatment has been demonstrated in several studies, with a relative risk reduction of 67% and a number-needed-to-treat of 51 2.
• Doxycycline is also the antimicrobial treatment of choice for other tick-borne diseases, including Rocky Mountain spotted fever, human monocytic ehrlichiosis, and human granulocytic ehrlichiosis 4, 5.

Timing and Administration

• The single dose of doxycycline should be given within 72 hours of tick removal 2, 3.
• The treatment can be administered in a primary care setting, and no serious adverse events have been reported 2.
• However, treatment with doxycycline has been associated with more frequent adverse effects, primarily nausea and vomiting 3.

Specific Patient Populations

• The use of doxycycline for prophylaxis after a tick bite is recommended for patients aged 8 years and older 2, 3.
• For patients with a high risk of Lyme disease, prophylactic treatment with doxycycline may be considered within 72 hours of tick removal 6.