Table 16.3.
Antibiotic treatment of tick-borne illnesses
| Tick-borne illness | Adults | Children |
|---|---|---|
| RMSF, R. rickettsii | Doxycycline 100 mg PO or IV BID for 5–7 days | Doxycycline 2 mg/kg PO or IV BID for 5–7 days (for children <45 kg) |
| Lyme disease |
Doxycycline 100 mg PO BID for 10–21 days Amoxicillin 500 mg PO TID for 14–21 days Cefuroxime axetil 500 mg PO BID for 14–21 days |
Doxycycline 2 mg/kg PO BID (max dose 100 mg) for 10–21 days Amoxicillin 50 mg/kg PO divided TID (max dose 500 mg) for 14–21 days Cefuroxime 30 mg/kg PO per day divided BID (max dose 500 mg) for 14–21 days |
| Ehrlichiosis |
Doxycycline 100 mg PO BID for 10 days Rifampin 300 mg PO BID for 10 days |
Doxycycline 2 mg/kg PO BID (max dose 100 mg) for 10 days Rifampin 10 mg/kg PO BID (max dose 300 mg) for 10 days |
| Babesiosis, B. microti |
(1) Atovaquone 750 mg orally every 12 h plus azithromycin 500 mg/d orally on day 1 and then 250 mg/d from day 2 onward for 7–10 days (2) Quinine 650 mg orally every 6–8 h plus clindamycin 600 mg orally every 8 h for 7–10 days#* For severe disease, consider clindamycin 300–600 mg IV every 6–8 h or 600 mg PO every 6–8 h plus quinine 650 mg PO every 6–8 h # Regiment (2) better tolerated *Treatment of choice during pregnancy |
(1) Atovaquone 20 mg/kg orally every 12 h (max 750 mg/dose) plus azithromycin 10 mg/kg orally on day 1 (max 500 mg) and then 5 mg/kg (max 250 mg/d) orally from day 2 onward for 7–10 days@ (2) Quinine 8 mg/kg orally every 8 h (max 650 mg/d) plus clindamycin 7–10 mg/kg orally every 6–8 h (max 600 mg/dose) for 7–10 days# For severe disease, consider clindamycin 7–10 mg/kg IV every 6–8 h (max 600 mg/dose) or 7–10 mg/kg PO every 6–8 h (max 600 mg/dose) @ Used safely in kids >5 kg # Regiment (2) better tolerated |
| Tick paralysis |
Removal of the tick Given that tick paralysis is not an infectious process, no specific antibiotic treatment is warranted unless evidence of an infectious process exists |
Removal of the tick Given that tick paralysis is not an infectious process, no specific antibiotic treatment is warranted unless evidence of an infectious process exists |