Clinical Tip No. 11: Doxycycline for Tick-Borne Diseases

🛑 THE PROBLEM
Ticks can transmit several bacterial diseases, including Lyme disease and various rickettsioses.
Coinfections are possible but are often not immediately obvious.

That’s why it makes sense to choose an antibiotic that can cover multiple potential pathogens from the start.

📚 THE BACKGROUND
Doxycycline is the first-line treatment for early Lyme disease.

Fortunately, doxycycline also provides coverage for other bacterial infections transmitted by ticks, such as anaplasmosis.
Of course, it does not treat viral infections like tick-borne encephalitis virus (TBEV).

✅ THE MESSAGE
If there are no contraindications, doxycycline (and not azithromycin) should be your first choice for Lyme disease and other bacterial tick-borne infections.

Most commonly used alternatives, such as beta-lactams (e.g. cefuroxime, amoxicillin), do not cover rickettsioses and may leave coinfections untreated.

This tip is especially relevant for family physicians and emergency medicine doctors.