What is the first-line treatment for Lyme disease in children and pregnant women?

The first-line treatment for Lyme disease in both children and pregnant women is amoxicillin. This is due to the favorable safety profile of amoxicillin for these populations and its effectiveness against Borrelia burgdorferi, the bacterium that causes Lyme disease. In children under eight years of age, doxycycline is generally avoided due to the risk of developing dental staining and other bone-related issues associated with tetracyclines.

Pregnant women also have similar concerns regarding the use of doxycycline, which is contraindicated during pregnancy. Amoxicillin, on the other hand, is safe for use during pregnancy and in young children, making it the preferred choice in these specific populations.

While ceftriaxone is effective for more severe manifestations of Lyme disease, such as neurologic or cardiac involvement, the initial treatment for early Lyme disease in children and pregnant women remains amoxicillin. Azithromycin is considered less effective and is typically not a first-line choice for Lyme disease.