Wormser GP et al. Clinical Infectious Diseases 2006;43:1089-1134. Republished with permission from University of Chicago Press. © 2006 by the Infectious Diseases Society of America. All rights reserved.

Table Two: Recommended antimicrobial regimens for treatment of patients with Lyme disease.

Drug Dosage for adults Dosage for children

Preferred oral regimens

     Amoxicillin 500 mg 3 times per day^a 50 mg/kg per day in 3 divided doses (maximum, 500 mg per dose)^a

     Doxycycline 100 mg twice per day^b Not recommended for children aged <8 years

For children aged 8 years, 4 mg/kg per day in 2 divided doses (maximum, 100 mg per dose)

     Cefuroxime axetil 500 mg twice per day 30 mg/kg per day in 2 divided doses (maximum, 500 mg per dose)

Alternative oral regimens

     Selected macrolides^c For recommended dosing regimens, see footnote d in table 3 For recommended dosing regimens, see footnote in table 3

Preferred parenteral regimen

     Ceftriaxone 2 g intravenously once per day 50–75 mg/kg intravenously per day in a single dose (maximum, 2 g)

Alternative parenteral regimens

     Cefotaxime 2 g intravenously every 8 h^d 150–200 mg/kg per day intravenously in 3–4 divided doses (maximum, 6 g per day)^d

     Penicillin G 18–24 million U per day intravenously, divided every 4 h^d 200,000–400,000 U/kg per day divided every 4 h^d (not to exceed 18–24 million U per day)

     ^a Althougha higher dosage giventwice per day mightbe equally as effective,in view of theabsence of data onefficacy, twice-daily administration isnot recommended.
     ^b Tetracyclines are relativelycontraindicated in pregnant orlactating women and inchildren <8 years ofage.
     ^c Because of their lowerefficacy, macrolides are reservedfor patients who areunable to take orwho are intolerant oftetracyclines, penicillins, and cephalosporins.
     ^d Dosageshould be reduced forpatients with impaired renalfunction.

Drug	Dosage for adults	Dosage for children
Preferred oral regimens
Amoxicillin	500 mg 3 times per day^a	50 mg/kg per day in 3 divided doses (maximum, 500 mg per dose)^a
Doxycycline	100 mg twice per day^b	Not recommended for children aged <8 years
		For children aged 8 years, 4 mg/kg per day in 2 divided doses (maximum, 100 mg per dose)
Cefuroxime axetil	500 mg twice per day	30 mg/kg per day in 2 divided doses (maximum, 500 mg per dose)
Alternative oral regimens
Selected macrolides^c	For recommended dosing regimens, see footnote d in table 3	For recommended dosing regimens, see footnote in table 3
Preferred parenteral regimen
Ceftriaxone	2 g intravenously once per day	50–75 mg/kg intravenously per day in a single dose (maximum, 2 g)
Alternative parenteral regimens
Cefotaxime	2 g intravenously every 8 h^d	150–200 mg/kg per day intravenously in 3–4 divided doses (maximum, 6 g per day)^d
Penicillin G	18–24 million U per day intravenously, divided every 4 h^d	200,000–400,000 U/kg per day divided every 4 h^d (not to exceed 18–24 million U per day)