Lyme Disease: Medications

Content provided by Healthwise

Medications

Antibiotics, such as doxycycline or amoxicillin, are the main treatment for Lyme disease.

The goals of treatment are to eliminate the infection and prevent complications of Lyme disease, such as problems involving the skin, joints, nervous system, or heart.

The type of antibiotic prescribed, the amount, and whether the medicine is taken orally, as an injection, or through a vein (intravenous or IV) depends on how bad your symptoms are and how long you've had Lyme disease. Oral antibiotics are prescribed for early Lyme disease. Either oral or intravenous antibiotics may be used to treat late Lyme disease symptoms.

Intravenous (IV) antibiotics are the treatment of choice if your nervous system is affected by late Lyme disease and you have bad headaches, neck pain, weakness or numbness in the arms or legs, or problems with thinking or memory. IV antibiotics are also used if the Lyme disease bacteria or antibodies against the bacteria have been found in your spinal fluid.

Oral antibiotics are usually prescribed first for chronic Lyme arthritis (recurring swelling and joint pain), but IV antibiotics may be tried if the oral antibiotics do not work.

Medication Choices

Antibiotics, such as doxycycline, amoxicillin, cefotaxime, or penicillin, are used to treat Lyme disease.

Taking doxycycline for 10 days may effectively treat early Lyme disease.⁶ Also, if doxycycline is given within 72 hours after you are bitten by an infected tick, it may prevent Lyme disease. The type of antibiotic your doctor gives you and the number of days you take it depends on your symptoms and the stage of the disease. Talk to your doctor if you have any questions about your antibiotic treatment.

There used to be a vaccine for prevention of Lyme disease in high-risk areas, but it is no longer available because of uncertainty over its effectiveness and lack of demand.

What To Think About

Different antibiotics may be used to treat children and adults. Doxycycline is often prescribed for adults and children 8 years and older, while amoxicillin is usually preferred for treating younger children with Lyme disease.⁷

The decision to take medicines for Lyme disease may be based on one or more of these factors:

• You have symptoms of Lyme disease, especially the characteristic red, circular rash , and a history of exposure to ticks in geographic regions where Lyme disease is known to occur.
• Blood tests reveal antibodies to the Lyme disease bacteria in your blood, spinal fluid, or joint fluid.
• You are a pregnant or breast-feeding and are bitten by a tick.

In rare instances, Lyme disease symptoms may not go away even after antibiotic treatment has cured the infection. There are a number of possible reasons why symptoms may take longer to improve:

• Some symptoms simply take longer to resolve.
• Tissue or nerve damage caused by untreated Lyme disease may be severe or even irreversible.
• You may not actually have Lyme disease or may have another illness at the same time with symptoms that do not respond to antibiotic treatment. Lyme disease may trigger fibromyalgia or chronic fatigue syndrome, or you may be misdiagnosed as having Lyme disease when you really have a chronic fatigue condition.

The first course of antibiotics almost always cures the infection. If symptoms continue, additional evaluation may be needed.

Last updated:	September 03, 2008
Author:	Maria G. Essig, MS, ELS
Reviewed By:	Kathleen Romito, MD - Family Medicine, Christine Hahn, MD - Epidemiology
Editors:	Susan Van Houten, RN, BSN, MBA, Pat Truman, MATC