01
DO NOT assume antibiotics are always inappropriate after a tick bite. The opposite blanket rule (always demand them) is also wrong.
02
CDC guidance describes a single 200 mg dose of doxycycline that may be considered for adults and children if specific criteria are met: the tick is identified as a black-legged tick, it was attached for 36 hours or more, prophylaxis can start within 72 hours of removal, and local Lyme infection rate in ticks is at least 20%.
03
The call belongs to a clinician who can weigh those criteria; do not self-prescribe and do not refuse a referral on principle.
04
For bites that do not meet the criteria, watch for rash, fever, fatigue, or joint aches over the next 30 days and follow up if any develop.
05
Always do a tick check, remove ticks promptly, and try to save the tick (in alcohol or a sealed bag) for identification.