From the Guidelines
For a tick bite, prophylactic antibiotic therapy should only be given to adults and children within 72 hours of removal of an identified high-risk tick bite, with a single dose of oral doxycycline being the recommended treatment 1. The decision to administer antibiotic prophylaxis depends on the risk level of the tick bite, which is determined by factors such as the tick species, the duration of attachment, and the geographic location of the bite 1. Key considerations for treatment 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 If these criteria are met, a single dose of oral doxycycline (200 mg for adults and 4.4 mg/kg for children, up to a maximum dose of 200 mg) is recommended within 72 hours of tick removal 1. It is essential to note that routine use of antimicrobial prophylaxis or serologic testing is not recommended for low-risk tick bites 1. After tick removal, the bite area should be cleaned with soap and water, and the individual should be monitored for signs of infection or rash, seeking medical attention if symptoms such as a bull's-eye rash, fever, or joint pain develop 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.
- Treatment for tick bite: Doxycycline is indicated for the treatment of tick fevers caused by Rickettsiae 2.
- Key points:
- Doxycycline is used to treat infections caused by susceptible bacteria.
- It is effective against certain tick-borne illnesses, such as Rocky Mountain spotted fever and tick fevers caused by Rickettsiae.
From the Research
Treatment for Tick Bite
- The use of single-dose doxycycline after high-risk tick bites can prevent Lyme disease 3
- Antibiotic prophylaxis, such as doxycycline, can be used to prevent Lyme disease after a tick bite, especially in areas where the disease is endemic 4
- A study found that the pooled rate of unfavorable events in persons receiving treatment was 0.4% compared to 2.2% in the control group, with a pooled risk ratio of 0.38 4
- Subgroup analysis revealed that single-use 200-mg doxycycline had a pooled risk ratio of 0.29, while a 10-day course of amoxicillin, penicillin, or tetracycline had a pooled risk ratio of 0.28 4
- Topical antibiotic treatment with azithromycin had a pooled risk ratio of 0.73, but further confirmation is needed 4
- Lyme disease postexposure prophylaxis may be underprescribed for some groups, including children 3