Lyme disease arthritis, Acrodermatitis chronic atrophicans

Refer to consultant rheumatologist for diagnosis and initial management of suspected Lyme arthritis. NSAIDs can be used during initial treatment. Re-treatment is indicated if non-response or relapse, please discuss re-treatment with consultant infection specialist or paediatrician.

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

28 days

Adults and children over 12 years old 
2nd line

Amoxicillin 1 gram three times daily

28 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

28 days

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

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

28 days

Children aged 9 to 12 years
2nd line

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

28 days

Children aged under 9 years  
1st line

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

28 days

Children aged under 9 years  
2nd line

Ceftriaxone (IV) (children 50kg and under) 
80mg per kg once daily

28 days

Last reviewed: 30 June 2018

Next review: 30 June 2021

Author(s): Area Antimicrobiology Team

Version: 3

Approved By: TAM Subgroup of ADTC

Reviewer Name(s): Area Antimicrobial Pharmacist

Document Id: AMT140