The bacterium, that is transmitted by a bite of an infected Ixodes scapularis tick (the black-legged or deer tick) Borrelia burgdorferi is the most common cause for Lyme disease in North-America. There are roughly ~476,000 cases per year. However, this number is heavily under-reported due to many variables regarding diagnosing Lyme disease accurately.
There are 4 stages of Lyme disease. (It is important to note that antibiotic treatment and stage class should go hand-in-hand regarding dosage/length of treatment.)
1.) Early localized Lyme disease – This stage mainly includes the notorious erythema migrans rash (bullseye). Note – this symptom is not indicative of every case of Lyme disease and only occurs in ~40% of confirmed cases. Flu-like symptoms are commonly reported, including fever, headache, and fatigue.
2.) Early disseminated Lyme disease – Once the window of early antibiotic treatment has passed, the next stage indicates that the bacteria has spread from the initial tick bite zone. Facial palsy, nerve pain, and nerve weakness are common symptoms of this stage.
3.) Late Lyme disease – Commonly reported symptoms include severe headaches, neck stiffness, arthritis, neurological complications, vertigo/dizziness, and numb limbs.
4.) Post-Lyme disease syndrome(s) – In some individuals, antibiotic treatment doesn’t seem to rid the infection completely. Instead, lingering symptoms and flare-ups occur throughout the individual’s life. The symptoms are generally chronic and vary. The common issues revolve around severe joint pain, extreme fatigue, brain fog, and severe headaches.
First-line oral antibiotics for Lyme disease and other tick-borne illnesses include doxycycline, amoxicillin, and cefuroxime. Intravenous administration of ceftriaxone is preferred for late stages of tick-borne diseases that cause neurological sequelae.
Doxycycline is the most well-known and used antibiotic in regard to Lyme disease and other tick-borne illnesses. This medication belongs to the tetracycline antibiotic class and is referred to as a bacteriostatic antibiotic because it halts growth of bacteria. Doxycycline has properties that can aid in controlling inflammation associated with things like rheumatoid arthritis, so it is a plus when given to patients with Lyme disease. In addition, it can cross multiple membranes within the body due to high lipophilicity, which allows it to target bacteria well as it can dissolve in fats, oils, and lipids more easily than other antibiotics.