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Lyme disease affecting the central nervous system (Antimicrobial)

Warning

If lumbar puncture is being performed, please note that CSF samples MUST be accompanied by serum taken on the same day. For further information, please see the Scottish Microbiology Reference Laboratory, Inverness: Lyme disease and tick-borne infections user manual.

For glossary of terms see Glossary.

Drug details

Adults and children over 12 years old
1st line

Ceftriaxone (IV) 2 grams twice daily 
OR
4 grams once daily

21 days

Adults and children over 12 years old 
2nd line

Doxycycline 200mg twice daily
OR
400mg once daily

21 days

Children aged 9 to 12 years
1st line

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

21 days

Children aged 9 to 12 years
2nd 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

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

Children aged under 9 years
1st line

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

21 days

Last reviewed: 30/06/2018

Next review date: 30/06/2021

Author(s): Area Antimicrobiology Team.

Version: 2

Approved By: TAM subgroup of ADTC

Reviewer name(s): Area Antimicrobial Pharmacist.

Document Id: AMT139