Attached >36 hours and removed ≤ 72 hours

Children ≥ 8 Years of age, known Ixodes tick attachment > 36 hours and within 72 hours of removal

Doxycycline 200 mg PO once*

*If <50 kg, 4 mg/kg to a maximum of 200 mg per day
Note amoxicillin is not recommended for prophylaxis due it's short half life

No need for serology in the context of prophylaxis

Children < 8 Years of age

Usually not recommended but prophylaxis may be recommended if there was a tick bite in an area that was known to be endemic for Lyme disease, and if the tick was engorged.

Doxycycline 4 mg/kg PO once

Monitor for early Lyme disease

SIGNS OF EARLY LYME DISEASE

Generally presents within 7-14 days of bite, up to 30 days.

70-80% of patients present with a classic Erythema Migrans (EM) rash which consists of a single erythematous, expanding, > 5 cm rash +/- central clearing at the site of the tick bite.

This may be associated with symptoms such as arthralgia, headaches, fatigue and fever.

If a person develops evidence of early Lyme disease, they should consult a physician and receive appropriate antimicrobial treatment (not prophylaxis).