Erythema migrans (EM) and/or non-focal symptoms (e.g 'flu-like' symptoms)

For glossary of terms see Glossary

Drug details

Adults and children over 12 years old
1st line

Doxycycline 100mg twice daily
OR
200mg once daily

21 days see further information section (b) as 14 days may be adequate  

Adults and children over 12 years old 
2nd line

Amoxicillin 1 gram three times daily

21 days

Children aged 9 to 12 years
1st line
see further information (a)

Doxycycline (children under 45kg)
2·5mg per kg twice daily on day one
then

2·5mg per kg daily in 1 or 2 divided doses

21 days see further information section (b) as 14 days may be adequate

Children aged 9 to 12 years 
For severe infections
see further information (a)

Doxycycline (children under 45kg)
up to 5mg per kg once daily

21 days see further information section (b) as 14 days may be adequate

Children aged 9 to 12 years
2nd line

Amoxicillin (children 33kg and under) 
30mg per kg three times daily

21 days

Children aged under 9 years 
1st line

Amoxicillin (children 33kg and under) 
30mg per kg three times daily

21 days  

Children aged under 9 years  
2nd line
see further information (c, d)

Azithromycin (children 50kg and under) 
10mg per kg once daily

17 days

Last reviewed: 31 August 2021

Next review: 31 August 2024

Author(s): Area Antimicrobiology Team

Version: 3

Approved By: TAM subgroup of ADTC

Reviewer Name(s): Area Antimicrobial Pharmacist

Document Id: AMT137