Discharge Instructions After Prophylactic Doxycycline for Tick Bite

Monitoring for Signs and Symptoms

The patient should monitor for symptoms of Lyme disease for 30 days, particularly watching for the development of an expanding skin lesion (erythema migrans) at the bite site or any flu-like symptoms, and seek immediate medical attention if these occur, as recommended by the Clinical Infectious Diseases guidelines 1
Monitor the tick bite site for 30 days for development of an expanding red rash (erythema migrans), which may appear as a "bull's-eye" pattern and is the hallmark sign of early Lyme disease, according to Clinical Infectious Diseases 1, 2
Watch for flu-like symptoms including fever, chills, fatigue, body aches, headache, and swollen lymph nodes, as suggested by Arthritis and Rheumatology 3

A single 200mg dose of doxycycline is the complete prophylactic regimen, and no additional doses are required, as stated by Arthritis care & research 4

Use protective clothing and EPA-registered tick repellents (DEET, picaridin, IR3535, oil of lemon eucalyptus, PMD, 2-undecanone, or permethrin) when in tick-endemic areas, as recommended by Arthritis and Rheumatology and Clinical Infectious Diseases 3, 5
Perform daily full-body tick checks when in tick-endemic areas, as suggested by Clinical Infectious Diseases 1
Remove attached ticks promptly using fine-tipped tweezers, grasping the tick as close to the skin surface as possible and pulling upward with steady pressure, according to Arthritis and Rheumatology 6

Return immediately if you develop an expanding rash at the bite site or anywhere else on your body, as recommended by Clinical Infectious Diseases 1, 2
Seek medical care if you develop fever, headache, fatigue, muscle/joint pain, or other concerning symptoms within 30 days of the tick bite, as suggested by Clinical Infectious Diseases 1

The single dose of doxycycline is most effective when the tick was attached for ≥36 hours, was an Ixodes species (blacklegged tick), and was removed in a highly endemic area, as stated by Arthritis and Rheumatology and Arthritis care & research 3, 4
Testing for Lyme disease is not recommended in asymptomatic individuals following a tick bite, even after receiving prophylaxis, according to Arthritis and Rheumatology and Arthritis care & research 3, 4