Use amoxicillin as an alternative first-line antibiotic

Amoxicillin is an effective alternative to doxycycline for early Lyme disease, particularly for pregnant women and young children. Adults take 500 mg three times daily for 14 days. Children receive 50 mg/kg daily divided into three doses (max 500 mg per dose).

Why It Works

Amoxicillin is a beta-lactam antibiotic that disrupts Borrelia cell wall synthesis. It has comparable efficacy to doxycycline for erythema migrans and is recommended by 2020 IDSA guidelines as an equally effective first-line option.

Tips

• Preferred over doxycycline for pregnant or breastfeeding women
• Can be taken with or without food
• Complete the full 14-day course even if symptoms resolve early
• Cefuroxime axetil (500 mg twice daily for 14 days) is another alternative if both doxycycline and amoxicillin are contraindicated