Prevention and Treatment of Lyme Disease

GUIDELINE TITLE Clinical Practice Guidelines by the Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), and American College of Rheumatology (ACR): 2020 Guidelines for the Prevention, Diagnosis and Treatment of Lyme Disease DEVELOPERS AND FUNDING SOURCE IDSA, AAN, and ACR RELEASE DATE November 30, 2020 PRIOR VERSION 2010 TARGET POPULATION Adults and children with suspected Lyme disease MAJOR RECOMMENDATIONS " Antibiotic prophylaxis with 1 dose of oral doxycycline (strong recommendation; moderate quality of evidence [QOE]) is recommended within 72 hours of tick removal after a high -risk bite (strong recommendation; high Q0E). " Erythema migrans should be treated with a 10 -day course of doxycycline or a 14 -day course of either amoxicillin or cefuroxime axetil (strong recommendation; moderate QOE). " For acute neurologic manifestations of Lyme disease, a 14- to 21 -day course of intravenous ceftriaxone, cefotaxime, penicillin G, or oral doxycycline is recommended (strong recommendation; moderate QOE). " Oral doxycycline, amoxicillin, or cefuroxime axetil for 28 days are recommended for treatment of Lyme arthritis (strong recommendation; moderate QOE). " Additional antibiotic therapy is not recommended for patients with persistent or recurring nonspecific symptoms (eg, fatigue, pain) who do not have evidence of reinfection or treatment failure (strong recommendation; moderate QOE).