See the parts in bold, it is pasted from the official ILADS guidelines. I advise you print the guidelines (link in the end) and go with it to your dr, if he is not lyme literate... But i think you should be reading the whole thing as it has to do with prohylaxis of lyme
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Q1. Does a single 200 mg dose of doxycycline following a tick bite provide effective prophylaxis for Lyme disease?
Organizational values
The panel placed a high value on preventing disease, thereby avoiding both the unnecessary progression from a potentially preventable infection to one that is chronic and associated with significant morbidity and costs. The panel placed a high value on not causing the abrogation of the immune response. The panel also placed a high value on the ability of the clinician to exercise clinical judgment. In the view of the panel, guidelines should not constrain the treating clinician from exercising clinical judgment in the absence of strong and compelling evidence to the contrary.
Recommendation 1a
Clinicians should not use a single 200 mg dose of doxycycline for Lyme disease prophylaxis (Recommendation, very low-quality evidence).
ROLE OF PATIENT PREFERENCES
Low: The relative trade-offs between risks and benefits are clear enough that most patients will place a high value on avoiding a seronegative state and its attendant delays in diagnosis and treatment.
Recommendation 1b
Clinicians should promptly offer antibiotic prophylaxis for known Ixodes tick bites in which there is evidence of tick feeding, regardless of the degree of tick engorgement or the infection rate in the local tick population. The preferred regimen is 100–200 mg of doxycycline, twice daily for 20 days. Other treatment options may be appropriate on an individualized basis (Recommendation, very low-quality evidence).
ROLE OF PATIENT PREFERENCES
Moderate: Most patients will place a high value on preventing chronic illness. However, some patients will value avoiding unnecessary antibiotics and prefer to not treat a tick bite prophylactically. Hence, treatment risks, benefits and options should be discussed with the patient in the context of shared medical decision-making.
Recommendation 1c
During the initial visit, clinicians should educate patients regarding the prevention of future tick bites, the potential manifestations of both early and late Lyme disease and the manifestations of the other tick-borne diseases that may have been contracted as a result of the recent bite. Patients receiving antibiotic prophylaxis should also be given information describing the symptoms and signs of a Clostridium difficile infection and the preventative effect of probiotics. Patients should be encouraged to immediately report the occurrence of any and all tick-borne disease manifestations and manifestations suggestive of a C. difficile infection (Recommendation, very low-quality evidence).
ROLE OF PATIENT PREFERENCES
Low: The benefits of educating patients about
potential disease manifestations clearly outweigh any attendant risks associated with education.
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www.tandfonline.com/doi/full/10.1586/14787210.2014.940900