21-day doxycycline course for confirmed early Lyme (adult)
For confirmed early localized Lyme in non-pregnant adults, IDSA recommends doxycycline 100 mg twice daily for 10-14 days, with up to 21 days for early disseminated disease.
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Steps
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Diagnosis is clinical when an erythema migrans rash is present in an endemic area; serology is not required.
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Standard regimen: doxycycline 100 mg orally twice daily.
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Duration is 10-14 days for early localized disease and up to 21 days for early disseminated disease per current IDSA guidance.
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Take with a full glass of water, sit upright for 30 minutes, and avoid lying down right after to prevent esophageal irritation.
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Use sun protection during treatment; doxycycline causes photosensitivity.
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Finish the course even if you feel better at day 5.