Lyme Disease

When to Provide Prophylaxis
  1. The attached tick can be reliably identified as an adult or nymphal I. scapularis tick that is estimated to have been attached for ≥36 hours on the basis of the degree of engorgement of the tick with blood or on certainty about the time of exposure to the tick.
  2. Prophylaxis can be started within 72 hours of the time that the tick was removed.
  3. Ecologic information indicates that the local rate of infection of these ticks with B. burgdorferi is ≥20 percent.
  4. Doxycycline is not contraindicated."
Source: Clin Infect Dis. 2006;43:1089-1134.