For the early Lyme EM rash, doctors usually prescribe two to three weeks of antibiotics. Doxycycline is the preferred treatment. Alternative antibiotics include amoxicillin and cefuroxime (Ceftin).In people who have developed Bell's palsy, arthritis or carditis, this antibiotic treatment often is extended to four weeks.
Some people with heart or neurological problems will be treated with antibiotics such as ceftriaxone (Rocephin) given intravenously (into a vein) for two to four weeks. Intravenous treatment also may be recommended if a person with Lyme arthritis does not respond to oral antibiotics. Doxycycline should be avoided in children less than 8 years old and for women who are pregnant or nursing. Erythromycin, azithromycin or clarithromycin may be less effective but are often prescribed for people with Lyme disease who can't tolerate the other options mentioned above.