Table 3.

Recommended Routes and Durations of Treatment for Lyme Disease

Clinical Manifestations by Disease StageTreatmentDuration, d
Early localized disease
 Erythema migransOral14–21a
Early disseminated disease
 Multiple erythema migransOral14–21
 Isolated cranial nerve palsyOral14–21
 MeningitisIntravenousb10–21
 Carditis
  AmbulatoryOral14–21
  HospitalizedIntravenous followed by oralc14–21
Late disease
 ArthritisOral28
 Recurrent or persistent arthritis after oral therapyOral or intravenous28
14–28
 EncephalitisIntravenous14–28
  • a Doxycycline may be administered for 10 days in uncomplicated cases.

  • b Doxycycline may be substituted after symptoms have resolved.

  • c At the time of discharge, the patient may receive oral medication to complete therapy.