Table 1 Antibiotic therapy for early Borrelia burgdorferi infection

General symptoms

Influenza-like disease

• Amoxicillin 50 mg/kg/day in three divided doses (maximum dose 1,500 mg/day)

• Doxycycline 4 mg/kg/day in two divided doses (maximum 200 mg/day; after 8 years of age)

for 14 days

Skin

Erythema migrans

• Amoxicillin 50 mg/kg/day in three divided doses (maximum dose 1,500 mg/day)

• Cefuroxime axetil 20 to 30 mg/kg/day in two divided doses (maximum dose 1,000 mg/day)

• Doxycycline 4 mg/kg/day in two divided doses (maximum 200 mg/day; after 8 years of age)

for 14 days or

Lymphocytoma

for 28 days

Neurologic disease

Lymphocytic meningitis

• Intravenous ceftriaxone 50 mg/kg/day in one dose (maximum dose 2,000 mg/day)

Cranial neuritis, in particular facial nerve

• Intravenous cefotaxime 200 mg/kg/day in three divided doses (maximum dose 6,000 mg/day)

Cardiac disease

Myopericarditis

• Intravenous penicillin G 0.5 million U/kg/day in four to six divided doses (maximum 20 million U/day)

for 14 days

• Doxycycline 4 mg/kg/day in two divided doses (maximum 200 mg/day; after 8 years of age)

for 14 to 28 days

Eye

Conjunctivitis (in case of influenza-like disease)

• Amoxicillin 50 mg/kg/day in three divided doses (maximum dose 1,500 mg/day)

Joint, muscle

Arthralgia

• Doxycycline 4 mg/kg/day in two divided doses (maximum 200 mg/day; after 8 years of age)

for 14 days