Family Nurse Practitioner Exam

What is the recommended treatment for erythema migrans or early Lyme disease?

1. Doxycycline (Vibramycin) 100 mg PO BID x 21 days

2. Ciprofloxacin (Cipro) 250 mg PO BID x 14 days

3. Erythromycin (E-mycin) 333 mg PO TID x 10 days

4. Dicloxacillin 500 mg PO BID x 10 days

The correct answer is: Doxycycline (Vibramycin) 100 mg PO BID x 21 days

The recommended treatment for erythema migrans or early Lyme disease is doxycycline at a dosage of 100 mg taken orally twice a day for a duration of 21 days. This antibiotic is effective against the spirochete Borrelia burgdorferi, which causes Lyme disease. Doxycycline is a tetracycline antibiotic that works by inhibiting protein synthesis in bacteria, thereby stopping their growth. Its efficacy in treating Lyme disease, particularly in the early stages where symptoms like erythema migrans are present, is well-documented. Additionally, doxycycline is often preferred for its ability to effectively penetrate host tissues and its relatively safe profile, even when considering patients who are pregnant or have renal insufficiencies, as alternatives may pose risks or be less effective. The other treatment options listed are not recommended for early Lyme disease due to either lack of efficacy against Borrelia burgdorferi or inappropriate dosing regimens. For instance, ciprofloxacin is primarily effective against gram-negative bacteria and is not effective against Lyme disease. Similarly, erythromycin, while a macrolide antibiotic with some broad-spectrum activity, is not the primary treatment for Lyme disease and has shown less efficacy compared to doxycycline. Lastly, dicloxacillin