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Erythema migrans — UKMLA MCQ

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HardInfectious DiseasesErythema migransUKMLAMRCGP AKTMRCEM SBAMRCP Part 1PSA

An immunocompetent adult has a classic erythema migrans rash without focal neurological, cardiac or joint involvement. They are not pregnant and have no relevant allergy. Which oral regimen is recommended?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Doxycycline 100 mg twice daily for 21 days

For adults and young people aged 12 or over with erythema migrans or other non-focal Lyme disease, NICE recommends oral doxycycline 100 mg twice daily, or 200 mg once daily, for 21 days. Amoxicillin is an alternative at the guideline dose when doxycycline is unsuitable. A classic erythema migrans rash is diagnosed clinically and treatment should not wait for serology. Intravenous ceftriaxone is reserved for specified focal manifestations and is unnecessary for uncomplicated isolated erythema migrans.

Reference: NICE NG95, antibiotic treatment for erythema migrans: https://www.nice.org.uk/guidance/ng95/chapter/recommendations