Lyme Disease: When To Treat Prophylactically
Despite the early season, I’ve already had about a half dozen patients reporting tick bites. So just to review, here are the guidelines for treating with doxycycline 200mg, as a prophylactic measure:
- The tick must be a proven deer tick in the nymph or adult tick stage
- The tick has been attached for at least 36 hours
- Treatment is begun within 72 hours of removing the tick
- You live in an endemic area, described as having a deer tick infection rate of at least 20%
- There is no contra-indication for taking doxycycline
All five criteria should be met to be given prophylactic treatment although ensuring that can be very difficult in some situations. At that point, the busy clinician will often go ahead and prescribe it even if there is no positive identification of the tick.
Just after I finished this article, I pulled a tick off me that had been attached no more than several hours. This, thankfully, has happened that often to me. Once I was flying over to Plymouth (I’m a private pilot) with a friend of mine, I scratched my neck only to discover a tick. I simply pulled it off, opened the little side window, and threw it out. It wasn’t quite the ride the tick had expected.