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The current recommendation for prophylaxis of Lyme disease after a tick bite is a 10- to 14-day course of amoxicillin or doxycycline. These investigators evaluated the efficacy of a single 200-mg dose of doxycycline in a randomized, placebo-controlled study of 482 patients who had removed Ixodes scapularis ticks from their bodies within the previous 72 hours.
Erythema migrans developed at the site of the tick bite a median of 12 days after tick removal (range, 4-17 days) in 8 (3.2 percent) of the 247 placebo recipients versus 1 of the 235 doxycycline recipients (0.4 percent; P < 0.04). Other manifestations of Lyme disease, such as facial nerve palsy, meningitis, heart block, and oligoarthritis were not observed during the 6-week study period…