Spectrum: Local Antimicrobial Stewardship, for CHEO-OCTC

Cutaneous disease - Erythema migrans (single or multiple) only

Notes

With no neurological/cardiac signs or symptoms

Erythema Migrans Rashes

Infection Prevention and Control

Routine Practices

Most Likely Pathogen

Borellia burgdorferi

Suggested Regimen

Doxycycline 4.4 mg/kg/24h PO divided q12h for 10 days
Maximum: 200mg/24h

OR

Amoxicillin 50 mg/kg/24h PO divided q8h for 14 days
Maximum: 1.5 gram/24h

OR

Penicillin V 50-100 mg/kg/24h PO divided q8h for 14 days
Maximum: 1.0 gram/24h

Penicillin Allergy

Cefuroxime 30 mg/kg/24h PO divided q12h for 14 days
Maximum: 1 gram /24h

If unable to take a beta-lactam or doxycycline

Azithromycin 10 mg/kg/day PO once daily for 7 days but this is considered second-line therapy