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Infection

Lyme Disease Possible therapeutic alternatives
Tick Exposure Borrelia burgdorferi
Prompt tick removal. Single dose doxycycline 200mg if: <72hr in epidemic area (NEJM 2001;345:79)

Prophylactic:  Doxycycline 200mg orally x 1 within 72 hours post tick bite - 87% effective, best only in highly endemic region.

Lyme disease - Erythema migrans  
Preferred:
Doxycycline 100mg orally twice daily x 10-14 days. 
Alternatives:
Amoxicillin 500mg orally three times daily x 14-21 days or 
Cefuroxime axetil (Ceftin)
500mg orally twice daily  x 14-21 days.
 
Lyme disease - Early Disseminated or Late complications
Bells palsy
Doxycycline
100mg orally twice daily x 21-28 days or 
Amoxicillin
500mg orally three times daily x 21-28 days.
CNS (other)
Ceftriaxone
2g IV q12h x 14-28 days or 
Cefotaxime
2g IV q6h x 14-28 days or 
Penicillin G
 
4 MU IV q 4h x 14-28 days.
Cardiac first degree block
Doxycycline 100mg orally twice daily x 21-28 days or 
Amoxicillin
500mg orally three times daily x 21-28 days.
Arthritis
oral
: Doxycycline 100mg orally twice daily x 28 days or Amoxicillin 500mg orally three times daily x 28 days.

IV: Cefotaxime 2g IV q8h x 14-28 days or Penicillin G 18-24 mil U IV qd x 14-28 days.

Images

Tick bite

lyme_dx

Lyme Disease