Pedemy All toolsTap the question, enter the weight, and get the answer with doses in mg and mL. Prophylaxis is only for high-risk bites; Lyme treatment follows the stage of disease.
This tool helps clinicians manage tick bites and Lyme disease in children. For a tick bite without symptoms, it asks the four questions that define a high-risk bite in the 2020 IDSA, AAN and ACR guideline: an identified Ixodes (blacklegged) tick, a highly endemic area, attachment for 36 hours or more, and presentation within 72 hours of removal. If all are met it gives a single dose of doxycycline, 4.4 mg/kg up to 200 mg, in mg and mL of 25 mg/5 mL suspension. Otherwise it advises watching for 30 days.
For Lyme disease it gives weight-based doses by stage. Erythema migrans is a clinical diagnosis treated with doxycycline for 10 days or amoxicillin or cefuroxime for 14 days, with azithromycin only as a fallback. Facial palsy gets doxycycline for 14 to 21 days; meningitis and radiculoneuritis get oral doxycycline or IV ceftriaxone 50 to 75 mg/kg for 14 to 21 days. Carditis with a PR interval of 300 ms or more, or higher-grade block, needs admission and IV ceftriaxone. Arthritis gets 28 days of oral therapy.
Doses show both mg per dose and mL of the common US suspensions: doxycycline 25 mg/5 mL, amoxicillin 400 mg/5 mL or 250 mg/5 mL and azithromycin 200 mg/5 mL, with adult maximums applied. The AAP allows doxycycline at any age for courses of 21 days or less. The page also covers tick removal, two-tier serology, and when to suspect Rocky Mountain spotted fever and other tick-borne infections that need doxycycline at once, at 2.2 mg/kg twice daily.
Only for a high-risk bite: an identified Ixodes tick, in a highly endemic area, attached for 36 hours or more (engorged), and within 72 hours of removal. The dose is a single 4.4 mg/kg dose, maximum 200 mg, at any age. If any criterion is missing, watch for symptoms for 30 days instead.
Yes for courses of 21 days or less. The AAP Red Book allows short doxycycline courses regardless of age, so it can be used for prophylaxis, erythema migrans, facial palsy, meningitis and carditis. For the 28-day arthritis course, CDC lists doxycycline for ages 8 and up, so use amoxicillin or cefuroxime in younger children.
No. A typical erythema migrans rash after possible exposure in an endemic area is a clinical diagnosis, and serology is often negative in the first weeks. Use two-tier serology for disseminated or late disease, and do not test asymptomatic children after a tick bite or the tick itself.
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